SOUTH TOWN DENTAL CARE, INC. (NPI# 1043776644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043776644 |
| Entity Type | Organization |
| Organization Name | SOUTH TOWN DENTAL CARE, INC. |
| Practice Address |
10720 W Indian School Rd Ste 55 Phoenix AZ 85037-5724 |
| Mailing Address |
7205 E Southern Ave Ste A-122 Mesa AZ 85209-2790 |
| Practice Telephone | 6238771729 |
| Mailing Telephone | 6023914107 |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2019-02-19 |
| Authorized Official Name | TIM J WILDUNG (CEO / TREASURER) |
| Authorized Official Telephone | 6023914107 |
| 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 |
|---|---|
| Garden Lakes Family Dentistry | Doing Business As Name - Organization |
| Street Address |
10720 W INDIAN SCHOOL RD STE 55 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85037-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477177491 | Erisa Sam | Dentist | 10720 W Indian School Rd Ste 55, Phoenix, AZ 85037-5724 | 2020-06-05 |
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|---|---|---|---|---|
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| 1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
| 1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
| 1740751320 | Mariposa Phoenix Al Partners, Lp | Assisted Living Facility | 3100 N 91st Avenue, Phoenix, AZ 85037 | 2018-12-08 |
| 1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
| 1922522242 | Tree of Life Mental Health Systems, LLC | Behavior Technician | 8400 W. Virginia, #1138, Phoenix, AZ 85037 | 2017-07-28 |
| 1720500465 | Moc Phoenix, LLC | Assisted Living Facility | 3000 N. 91st Avenue, Phoenix, AZ 85037 | 2017-07-14 |
| 1407385826 | Not Alone Home Care, LLC | In Home Supportive Care | 9422 W Palm Lane, Phoenix, AZ 85037 | 2017-06-08 |
| 1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
| Find all providers in zip 85037 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1336751536 | Smile Nuvo | Clinic/Center | 2142 W Red Fox Rd, Phoenix, AZ 85085-5458 | 2020-08-19 |
| 1942821301 | Family and Kids Dental LLC | Clinic/Center | 2610 W Baseline Rd Ste 120, Phoenix, AZ 85041-6400 | 2020-04-27 |
| 1003458688 | Uptown Pediatric Dental Group, Pllc | Clinic/Center | 1515 E Missouri Ave Ste 103, Phoenix, AZ 85014-2443 | 2019-10-15 |
| 1538720818 | Scott A. Simpson Dds Pllc | Clinic/Center | 14231 N 7th St Ste A14231n7, Phoenix, AZ 85022-4360 | 2019-06-26 |
| 1992362891 | Lemon Tree Dentistry LLC | Clinic/Center | 1985 W Happy Valley Rd Ste 115, Phoenix, AZ 85085-2888 | 2019-05-26 |
| 1457813768 | Singh Smile Care | Clinic/Center | 3201 W Peoria Ave Ste A103, Phoenix, AZ 85029-4609 | 2019-04-04 |
| 1710447370 | Minted Dental | Clinic/Center | 21050 N Tatum Blvd Ste 200, Phoenix, AZ 85050-4262 | 2019-03-20 |
| 1679032197 | Denkha Dentistry, LLC | Clinic/Center | 1601 E Bell Rd Ste A13, Phoenix, AZ 85022-6254 | 2019-03-14 |
| Find all providers in PHOENIX | ||||
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| 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.