DR. MARK G PRUSACKI (NPI# 1467667071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467667071 |
| Entity Type | Individual |
| Full Name | DR. MARK G PRUSACKI |
| Credential | DDS |
| Practice Address |
16415 S 46th Way Phoenix AZ 85048-0158 |
| Practice Telephone | 4805674212 |
| Mailing Telephone | 4807530529 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2013-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4705 | AZ | Dental Providers |
| Street Address |
16415 S 46TH WAY |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85048-0158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164062618 | Smile Dentistry Pllc | Dentist | 1238 E. Chandler Blvd. #101, Phoenix, AZ 85048 | 2020-01-13 |
| 1558924415 | Ahwatukee Orthodontic Associates Inc | Dentist | 16611 S. 40th Street, Suite 110, Phoenix, AZ 85048 | 2019-04-17 |
| 1699299560 | Brianna Alean Kinsey | Student in an Organized Health Care Education/Training Program | 16214 S. 1st Street, Phoenix, AZ 85048 | 2017-08-01 |
| 1497278113 | Teague Duncan Wilson | Specialist/Technologist | 3305 E Nighthawk Way, Phoenix, AZ 85048 | 2017-07-25 |
| 1730550146 | Jennifer Zazueta | Physician Assistant | 4126 E Nighthawk Way, Phoenix, AZ 85048 | 2015-10-12 |
| 1235551904 | Louise Marie Braunbeck | Physical Therapy Assistant | 16649 S 24th Place, Phoenix, AZ 85048 | 2014-01-14 |
| 1780026260 | Erin Onacki | Social Worker | 4530 E Muirwood Dr. Suite 103, Phoenix, AZ 85048 | 2013-07-24 |
| 1649528720 | Cody A Morales | Social Worker | 4654 E Mountain Vista Dr, Phoenix, AZ 85048 | 2012-08-21 |
| 1417168287 | Lori Lynn Haas | Social Worker | 4025 E. Chandler Boulevard, #70-e7, Phoenix, AZ 85048 | 2007-05-24 |
| 1285847210 | Jonne Amorette Housh | Nurse Practitioner | 4545 E Chandler Blvd., Phoenix, AZ 85048 | 2007-05-07 |
| Find all providers in zip 85048 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205441136 | Maryvale Dental Studio | Dentist | 7614 W Indian School Rd # 2, Phoenix, AZ 85033-3035 | 2020-09-08 |
| 1912516535 | Ford Calaway Dentistry & Orthodontics LLC | Dentist | 2111 E Highland Ave Ste B, Phoenix, AZ 85016-4741 | 2020-07-29 |
| 1568085637 | Family Dental Phoenix | Dentist | 2401 W Glendale Ave Ste 102, Phoenix, AZ 85021-7621 | 2020-05-24 |
| 1699308866 | Signature Dental Partners LLC | Dentist | 410 N 44th St Ste 290, Phoenix, AZ 85008-7622 | 2020-02-17 |
| 1164062618 | Smile Dentistry Pllc | Dentist | 1238 E. Chandler Blvd. #101, Phoenix, AZ 85048 | 2020-01-13 |
| 1942849146 | Risas O.s. Dental Partners Az LLC | Dentist | 7442 W. Thomas Rd., Phoenix, AZ 85033 | 2020-01-06 |
| 1831748532 | Benjamin Paul Chalom Baranes | Dentist | 5225 N 19th Ave Ste C, Phoenix, AZ 85015-2903 | 2019-09-05 |
| 1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
| 1376101188 | Bethany Helen Armendariz | Dentist | 4757 E Greenway Rd # Set108, Phoenix, AZ 85032-8513 | 2019-06-05 |
| 1851958300 | Smile Dental Studio | Dentist | 10209 N 35th Ave Ste 129, Phoenix, AZ 85051-9619 | 2019-05-21 |
| 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.