PREVENTATIVE DENTAL CARE PLLC (NPI# 1033690169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033690169 |
| Entity Type | Organization |
| Organization Name | PREVENTATIVE DENTAL CARE PLLC |
| Other Organization Name | CANYON DENTAL |
| Practice Address |
19251 E Oasis Dr Black Canyon City AZ 85324-8878 |
| Practice Telephone | 1623444232 |
| Mailing Telephone | 1623444232 |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |
| Authorized Official Name | SCOTT W HIRSBRUNNER (OWNER) |
| Authorized Official Telephone | 6234442322 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Canyon Dental | Doing Business As Name - Organization |
| Street Address |
19251 E OASIS DR |
| City | BLACK CANYON CITY |
| State | AZ |
| Zip Code | 85324-8878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467432971 | Randy Charles Hancock | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2006-01-19 |
| 1699166199 | Louella Bauman | Nurse Practitioner | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2015-02-05 |
| 1245558030 | Purim Way LLC | Pharmacy | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2010-05-04 |
| 1679723217 | Black Canyon Community Health Center | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2008-09-19 |
| 1780858878 | Andrea Kay Irving | Obstetrics & Gynecology | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2008-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834642 | Canyon Medical Clinic LLC | Family Medicine | 34501 S Old Black Canyon Hwy # 1, Black Canyon City, AZ 85324 | 2018-06-11 |
| 1356708655 | Home Health Services, Pllc | Clinic/Center | 19375 E. Oasis, Black Canyon City, AZ 85324 | 2016-01-19 |
| 1760669600 | Emd Medical Services LLC | Clinic/Center | 18850 E. Schoolhouse Road, Black Canyon City, AZ 85324 | 2008-01-22 |
| 1639380363 | Black Canyon City Dentistry LLC | Dentist | 34501 S Old Black Canyon City Highway, Suite 5, Black Canyon City, AZ 85324 | 2007-05-24 |
| 1477622405 | Kevin Carl Krause | Chiropractor | 34501 South Black Canyon Highway, Suite #3, Black Canyon City, AZ 85324 | 2006-11-06 |
| 1982669552 | Joshua Cheol-hong Kim | Internal Medicine | 34601 S. Phyllis St., Black Cayon City, AZ 85324 | 2006-04-18 |
| 1508079518 | Canon Elementary School District | Local Education Agency (LEA) | 34630 S School Loop Rd., Black Canyon City, AZ 85324-0089 | 2007-05-07 |
| 1265538474 | Marci Brown-gilpin | Counselor | 18850 E School House Rd, 3, Black Canyon City, AZ 85324-8787 | 2006-09-15 |
| 1669087599 | Heidi Marie Nida-huff | Nurse Practitioner | 19251 E Oasis Dr # 19251, Black Canyon City, AZ 85324-8878 | 2020-09-08 |
| 1336162866 | Elizabeth Marie Tarufelli | Nurse Practitioner | 18850 E School House Rd, Black Canyon City, AZ 85324-8925 | 2006-07-25 |
| Find all providers in zip 85324 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063329 | Trombetta Dental Solutions | Clinic/Center | 13808 N Sandario Rd Ste 100, Marana, AZ 85653-8940 | 2020-11-06 |
| 1629676903 | Dental and Braces Dysart LLC | Clinic/Center | 1450 N Dysart Rd Ste A7, Avondale, AZ 85323-1534 | 2020-10-09 |
| 1255946257 | Tatum Point Dentistry LLC | Clinic/Center | 4747 E Bell Rd Ste 15, Phoenix, AZ 85032-2301 | 2020-09-15 |
| 1003421009 | Solterra Dentistry LLC | Clinic/Center | 15255 N 40th St Ste 111, Phoenix, AZ 85032-4636 | 2020-09-15 |
| 1699389510 | Ocotillo Dental Associates LLC | Clinic/Center | 11259 S Frontage Rd Ste 103, Yuma, AZ 85367-7883 | 2020-09-08 |
| 1144832940 | Kingman Dental Professionals, LLC | Clinic/Center | 3775 N Stockton Hill Rd, Kingman, AZ 86409-3219 | 2020-08-21 |
| 1336751536 | Smile Nuvo | Clinic/Center | 2142 W Red Fox Rd, Phoenix, AZ 85085-5458 | 2020-08-19 |
| 1396354205 | Freedom Dental, Pllc | Clinic/Center | 6328 E Brown Rd Ste 105, Mesa, AZ 85205-4841 | 2020-07-27 |
| 1649888629 | Whitney A Sebree, Dmd Pllc | Clinic/Center | 15331 W Bell Rd Ste 204, Surprise, AZ 85374-4104 | 2020-07-16 |
| 1912520347 | Dr. Reese Turner, Dds, PC | Clinic/Center | 9059 W Lake Pleasant Pkwy Ste A100, Peoria, AZ 85382-8393 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | BLACK CANYON CITY |
| Zip Code | 85324 |
Please comment or provide details below to improve the information on PREVENTATIVE DENTAL CARE PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.