CENTRAL AVENUE SPECIALTY, PLLC. (NPI# 1104257963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104257963 |
Entity Type | Organization |
Organization Name | CENTRAL AVENUE SPECIALTY, PLLC. |
Practice Address |
5133 N Central Ave Suite 200 Phoenix AZ 85012-1438 |
Mailing Address |
5133 N Central Ave Suite 102 Phoenix AZ 85012-1438 |
Practice Telephone | 6022661776 |
Practice Fax Number | 6022341814 |
Mailing Telephone | 6022661776 |
Mailing Fax Number | 6022341814 |
Enumeration Date | 2013-12-04 |
Last Update Date | 2013-12-04 |
Authorized Official Name | DR. ANTHONY E HERRO (OWNER) |
Authorized Official Telephone | 6022661776 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223P0700X |
Dentist Specialization: Prosthodontics |
D008106 | AZ | Dental Providers |
N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D008035 | AZ | Dental Providers |
Y | 1223E0200X |
Dentist Specialization: Endodontics |
D07259 | AZ | Dental Providers |
Street Address |
5133 N CENTRAL AVE SUITE 200 |
City | PHOENIX |
State | AZ |
Zip Code | 85012-1438 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528039609 | William B Exley | Specialist | 5133 N Central Ave, Suite 200, Phoenix, AZ 85012-1438 | 2006-01-27 |
1629513486 | Az Surgical Center LLC | Clinic/Center | 5133 N Central Ave, Suite 100, Phoenix, AZ 85012-1438 | 2017-01-03 |
1396193843 | Desert Princess | Obstetrics & Gynecology | 5133 N Central Ave, 100, Phoenix, AZ 85012-1438 | 2016-05-25 |
1811352164 | Greater Arizona Anesthesia Specialists, Pllc | Anesthesiology | 5133 N Central Ave, Suite 100, Phoenix, AZ 85012-1438 | 2015-12-30 |
1427426915 | Advanced Pain Management, Inc. | Anesthesiology | 5133 N Central Ave, Suite 100, Phoenix, AZ 85012-1438 | 2015-09-14 |
1952536294 | Frederick Ellison Herro | Hospitalist | 5133 N Central Ave, Suite 200, Phoenix, AZ 85012-1438 | 2009-05-15 |
1437343738 | Anthony E. Herro Dds,pllc. | Dentist | 5133 N Central Ave, #102, Phoenix, AZ 85012-1438 | 2007-08-29 |
1417020330 | Robert Allen Williams | Psychiatry & Neurology | 5133 N Central Ave, Suite 107, Phoenix, AZ 85012-1438 | 2006-11-16 |
1295813228 | Greater Phoenix Physical Medicine | Physical Medicine & Rehabilitation | 5133 N Central Ave, Suite 101, Phoenix, AZ 85012-1438 | 2006-11-01 |
1033225214 | David J Domin Md PC | Specialist | 5133 N Central Ave, Ste 200, Phoenix, AZ 85012-1438 | 2006-08-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
Find all providers in zip 85012 |
Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083005136 | Baseline Dental, PC | Dentist | 2030 W Baseline Rd Ste 176, Phoenix, AZ 85041-6574 | 2015-02-11 |
1457767758 | Brandi L. Molina | Dentist | 702 E Bell Rd Ste 111, Phoenix, AZ 85022-6639 | 2014-07-08 |
1730496514 | Carl R Wright | Dentist | 15215 S 48th St Ste 136, Phoenix, AZ 85044-9138 | 2010-09-01 |
1891982443 | Emad Gus Khalifa | Dentist | 20950 N Tatum Blvd Ste 210, Phoenix, AZ 85050-4268 | 2007-09-27 |
1558567743 | Percy B. Twine | Dentist | 2020 W Baseline Rd Ste 172, Phoenix, AZ 85041-6573 | 2007-06-25 |
1972713493 | Eugene Salazar | Dentist | 706 E Bell Rd Ste 104, Phoenix, AZ 85022 | 2007-05-23 |
1831294032 | Kevin T Axx | Dentist | 4141 N 32nd St Ste 100, Phoenix, AZ 85018-4775 | 2006-09-13 |
1700811692 | Jacqueline Savannah Allen | Dentist | 6520 N 7th Ave, Suite 7, Phoenix, AZ 85013-1173 | 2006-07-11 |
1659308641 | North Valley Endodontics, P.a. | Dentist | 706 E Bell Road, Suite 106, Phoenix, AZ 85022-6640 | 2006-06-27 |
1427004654 | Victor A Palmieri | Dentist | 2737 E Brookwood Ct, Phoenix, AZ 85048-9359 | 2006-05-26 |
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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.