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DENTAL SPECIALISTS OF NW ARIZONA NPI 1831554930


NPI Information

NPI: 1831554930
Provider Name: DENTAL SPECIALISTS OF NW ARIZONA
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
2152 MCCULLOCH BLVD N STE C
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 854-5551
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DENTAL SPECIALISTS OF NW ARIZONA is a periodontics dentist in Lake Havasu City, AZ. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. DENTAL SPECIALISTS OF NW ARIZONA NPI is 1831554930. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2152 MCCULLOCH BLVD N STE C
LAKE HAVASU CITY, AZ
ZIP 86403-805
Phone: (928) 854-5551

The provider's authorized official is Ryan Lavene .
The authorized official title is Endodontist and has the following contact phone number (928) 854-5551.

The enumeration date for this NPI number is 12/16/2015 and was last updated on 12/16/2015.


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
11223E0200XDentistEndodontics8793ARIZONANo
21223P0300XDentistPeriodontics8823ARIZONAYes

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

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