Pepsquad Pllc

LBN: Pepsquad Pllc
Pepsquad Pllc is an health care organization with primary practice located at 5215 E Southern Ave , Mesa AZ 85206-2777. The organization recently has 4 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / Orthodontics and Dentofacial Orthopedics, Dental Providers / Denturist. Dental Providers / Dentist is the primary health care specialty. Pepsquad Pllc can be contacted via phone (509) 823-4480, or through Thompson, Derek via phone (509) 823-4480.

Contact Information

Primary practice address
5215 E Southern Ave Mesa AZ 85206-2777
Phone: (509) 823-4480
Fax: (509) 823-4490
Website:
Map and Directions
Authorized official contact:
Name: Thompson, Derek
Phone: (509) 823-4480

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X
Dental Providers / Denturist 122400000X

Profile Details

NPI number 1487228961
LBN Legal business name Pepsquad Pllc
DBA Doing business as
Authorized official Thompson, Derek
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2021
Last updated May 18th, 2021 - about 3 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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