FLAGSTAFF MODERN DENTISTRY (NPI# 1386033629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386033629 |
| Entity Type | Organization |
| Organization Name | FLAGSTAFF MODERN DENTISTRY |
| Other Organization Name | FLAGSTAFF MODERN DENTISTRY |
| Practice Address |
304 S Regent St, Suite 101 Flagstaff AZ 86001 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 9282267494 |
| Practice Fax Number | 9282267151 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |
| Authorized Official Name | DR. ALEX R SHARIFIAN (OWNER) |
| Authorized Official Telephone | 9282267494 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Flagstaff Modern Dentistry | Doing Business As Name - Organization |
| Street Address |
304 S REGENT ST, SUITE 101 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194341776 | Christian Jesus Mendoza | Dentist | 710 N Beaver St Bldg 2, Flagstaff, AZ 86001-3145 | 2020-06-19 |
| 1689237547 | Taylor Hunt | Dentist | 1600 W University Ave Ste 113, Flagstaff, AZ 86001-3154 | 2019-04-17 |
| 1083942940 | Vaughn Milton Oliver | Dentist | 1953 E Y X Ranch Rd, Flagstaff, AZ 86001-9407 | 2009-12-03 |
| 1093957946 | Louis Richard Haag | Dentist | 1815 N. Thistle Rd., Flagstaff, AZ 86004 | 2009-03-24 |
| 1073709366 | Brandon John Tilts | Dentist | 518 N Beaver St, Suite A, Flagstaff, AZ 86001-3020 | 2007-09-20 |
| 1104049089 | Flagstaff Dental Group, Pllc | Dentist | 10 W Hunt Ave, Flagstaff, AZ 86001-3018 | 2007-04-10 |
| 1437283165 | Royce T Peterson | Dentist | 3100 N West St Ste 100, Flagstaff, AZ 86004-1651 | 2007-03-15 |
| 1619018041 | Lawrence Alan Winse | Dentist | 2708 N 4th St, Ste F2, Flagstaff, AZ 86004 | 2007-02-09 |
| 1427198522 | John Leonard Bacon | Dentist | 323 N Leroux St Ste 100, Flagstaff, AZ 86001-4542 | 2007-02-07 |
| 1255496238 | Thomas J Grabarek | Dentist | 304 S Humphreys St, Flagstaff, AZ 86001-5623 | 2006-12-27 |
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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.