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LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC NPI 1699792788


NPI Information

NPI: 1699792788
Provider Name: LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 03D1017038

Address:
1939 MCCULLOCH BLVD N
STE 2
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 855-5041
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LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC is a general practice dentist in Lake Havasu City, AZ. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. LAKE HAVASU CITY VALLEY DENTAL ASSOCIATES PC NPI is 1699792788. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1939 MCCULLOCH BLVD N
STE 2
LAKE HAVASU CITY, AZ
ZIP 86403-652
Phone: (928) 855-5041
Fax: (928) 855-2757

The provider's authorized official is Betty Ann Horn .
The authorized official title is Administrative Director and has the following contact phone number (928) 855-5041.

The CLIA number assigned to this NPI record is 03D1017038 - community clinic with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeARIZONAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.