Phoenix Pediatric Dental, Llc

LBN: Phoenix Pediatric Dental, Llc
Phoenix Pediatric Dental, Llc is an health care organization with primary practice located at 6750 N 19Th Ave , Phoenix AZ 85015-1127. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Phoenix Pediatric Dental, Llc can be contacted via phone (602) 242-5741, or through Pacheco, Luz via phone (602) 242-5741.

Contact Information

Primary practice address
6750 N 19Th Ave Phoenix AZ 85015-1127
Phone: (602) 242-5741
Fax: (602) 242-5742
Website:
Map and Directions
Authorized official contact:
Name: Pacheco, Luz
Phone: (602) 242-5741

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X Arizona

Profile Details

NPI number 1891875498
LBN Legal business name Phoenix Pediatric Dental, Llc
DBA Doing business as
Authorized official Pacheco, Luz
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2006
Last updated Dec 23rd, 2014 - about 11 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 1891875498 NPPES
Arizona MEDICAID 409926
Arizona MEDICAID 627562
Arizona MEDICAID 570475
Arizona MEDICAID 883737
Arizona MEDICAID 450924
Arizona MEDICAID 796862

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