PHOENIX WISDOM TEETH, LLC (NPI# 1255945366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255945366 |
Entity Type | Organization |
Organization Name | PHOENIX WISDOM TEETH, LLC |
Practice Address |
17037 N 43rd Ave # A4a Glendale AZ 85308-4026 |
Mailing Address |
5513 W 11000 N # 226 Highland UT 84003-8012 |
Practice Telephone | 8014068670 |
Enumeration Date | 2020-09-04 |
Last Update Date | 2020-09-04 |
Authorized Official Name | RYAN ARNOLD (MANAGING MEMBER) |
Authorized Official Telephone | 8014068670 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
Other Name | Type Code |
---|---|
Wisdom Teeth Guys | Doing Business As Name - Organization |
Street Address |
17037 N 43RD AVE # A4A |
City | GLENDALE |
State | AZ |
Zip Code | 85308-4026 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
Find all providers in zip 85308 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750738555 | Omar Kholaki | Dentist | 3863 Sky View Ln, Glendale, CA 91214-1006 | 2016-05-21 |
1891182507 | Armand Keuroghlian | Dentist | 1044 Trafalger Dr, Glendale, CA 91207-1140 | 2015-04-20 |
1932518107 | Ara Mirzaians | Dentist | 500 N Central Ave Ste 710, Glendale, CA 91203-3386 | 2014-08-12 |
1134567381 | Eric Edward Saiz | Dentist | 6677 W Thunderbird Rd Ste H120, Glendale, AZ 85306-3726 | 2013-06-10 |
1376841015 | Christopher P. Mcaboy Dds, LLC | Dentist | 377 W River Woods Pkwy # 120, Glendale, WI 53212-1088 | 2011-03-04 |
1508196437 | Peter S Nelson | Dentist | 5750 W Thunderbird Rd Ste H850, Glendale, AZ 85306-4694 | 2009-12-25 |
1396868774 | Armond Kotikian | Dentist | 242 N. Glendale Ave, Glendale, CA 91206 | 2007-04-09 |
1316081623 | Hamlet Charmahali Garabedian | Dentist | 242 N Glendale Ave, Glendale, CA 91206-4454 | 2007-02-19 |
1689725780 | Joseph F Goodsell | Dentist | 1146 N Brand Blvd, Glendale, CA 91202-2504 | 2007-01-15 |
1427156330 | John E Darling | Dentist | 200 W Silver Spring Dr, Ste 285, Glendale, WI 53217-5059 | 2006-09-21 |
Find all providers in GLENDALE |
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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.