Santa Rosa Dental Clinic

LBN: Dhhs-Phs, Ihs Tucson Area, Ihs Tucson Santa Rosa Clinic
Santa Rosa Dental Clinic is an health care organization with primary practice located at Federal Route 15 , Santa Rosa Village AZ 85634. The organization recently has 4 registered licenses in different health care specialties including Dental Providers / Dental Public Health, Dental Providers / Pediatric Dentistry, Dental Providers / Dental Hygienist, Dental Providers / Dental Assistant. Dental Providers / Dental Public Health is the primary health care specialty. Dhhs-Phs, Ihs Tucson Area, Ihs Tucson Santa Rosa Clinic can be contacted via phone (520) 383-5570, or through Priessman, Kurt via phone (520) 295-2427.

Contact Information

Primary practice address
Federal Route 15 Santa Rosa Village AZ 85634
Phone: (520) 383-5570
Fax: (520) 383-5572
Website:
Map and Directions
Authorized official contact:
Name: Priessman, Kurt M.A., M.B.A., C.P.M.
Phone: (520) 295-2427

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X
Dental Providers / Pediatric Dentistry 1223P0221X
Dental Providers / Dental Hygienist 124Q00000X
Dental Providers / Dental Assistant 126800000X

Profile Details

NPI number 1164407870
LBN Legal business name Dhhs-Phs, Ihs Tucson Area, Ihs Tucson Santa Rosa Clinic
DBA Doing business as Santa Rosa Dental Clinic
Authorized official Priessman, Kurt M.A., M.B.A., C.P.M.
Entity Organization
Organization subpart 1 No
Enumeration date Dec 14th, 2005
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164407870 NPPES
Arizona Other 1770581639 FACILITY PROVIDER #
Arizona MEDICAID 147141-03 FACILITY PROVIDER #
Arizona Other AZ0209590 FACILITY PROVIDER #
Arizona Other 1073502506 FACILITY PROVIDER #
Arizona Other 0327177 FACILITY PROVIDER #
Arizona Other AZ0209630 FACILITY PROVIDER #

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