PDA HOLDINGS (NPI# 1134345937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134345937 |
Entity Type | Organization |
Organization Name | PDA HOLDINGS |
Other Organization Name | MAGIC SMILES DENTAL CARE |
Practice Address |
1701 E Thomas Rd #204 Phoenix AZ 85016 |
Practice Telephone | 6022536600 |
Practice Fax Number | 6022790821 |
Mailing Telephone | 6022536600 |
Mailing Fax Number | 6022790821 |
Enumeration Date | 2007-04-18 |
Last Update Date | 2015-05-12 |
Authorized Official Name | DANIEL MORRISSEY (PRESIDENT) |
Authorized Official Telephone | 6022536600 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | AHCCCS PROVIDER ID | 232643 | 01 |
Other Name | Type Code |
---|---|
Magic Smiles Dental Care | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
New York State Corporations | PDA HOLDINGS, LLC | #68, 1328 Broadway, Ste. 1024, New York, Ny 10001 |
Street Address |
1701 E THOMAS RD #204 |
City | PHOENIX |
State | AZ |
Zip Code | 85016 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
Find all providers in zip 85016 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881206274 | Totally Kids Dental P.C. | Dentist | 602 W Union Hills Dr Ste 9, Phoenix, AZ 85027-6629 | 2020-08-18 |
1861989121 | Logan Mariano | Dentist | 4383 E Rosemonte Dr, Phoenix, AZ 85050-3407 | 2018-04-21 |
1972023372 | David Jourabchi | Dentist | 4550 E Bell Rd Ste 106, Phoenix, AZ 85032-9342 | 2017-06-27 |
1730639840 | Steven Petruzzi Dds Pllc | Dentist | 34406 N 27th Dr Ste 106, Phoenix, AZ 85085-7730 | 2016-10-12 |
1124401146 | Jennifer Canada | Dentist | 6725 N 35th Ave # 105, Phoenix, AZ 85017-1083 | 2015-07-08 |
1548654791 | Arlene Kewallal | Dentist | 1935 W Happy Valley Rd, Phoenix, AZ 85085-2884 | 2015-03-25 |
1134400880 | Norterra Pediatric Dental Partners, LLP | Dentist | 2217 W Happy Valley Rd Ste 100, Phoenix, AZ 85085-1604 | 2011-09-07 |
1558689703 | Hamed Rezakhan | Dentist | 4803 E Ray Rd, Suit P002c, Phoenix, AZ 85044-6496 | 2010-05-12 |
1417110750 | Shreekrishna Chaitanya Akilesh | Dentist | 10550 W Mariposa St, Phoenix, AZ 85037-5081 | 2008-07-07 |
1902936677 | William J. Heimann | Dentist | 1526 W Glendale Ave Ste 103, Phoenix, AZ 85021-8576 | 2007-03-06 |
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.