DESERT RIDGE IMPLANT & ORAL SURGERY PC (NPI# 1588960512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588960512 |
| Entity Type | Organization |
| Organization Name | DESERT RIDGE IMPLANT & ORAL SURGERY PC |
| Practice Address |
20950 N Tatum Blvd Ste. 120 Phoenix AZ 85050-4200 |
| Practice Telephone | 4805633960 |
| Practice Fax Number | 4805633965 |
| Mailing Telephone | 4805633960 |
| Mailing Fax Number | 4805633965 |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-04-04 |
| Authorized Official Name | DR. MATTHEW A. DEFELICE (OWNER) |
| Authorized Official Telephone | 4805633960 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5196 | AZ | Dental Providers |
| Street Address |
20950 N TATUM BLVD STE. 120 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85050-4200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982604708 | Steven Cary Simon | Surgery | 20950 N Tatum Blvd, Suite 308, Phoenix, AZ 85050-4200 | 2005-07-22 |
| 1689110314 | Trusted Care Surgery Centers LLC | Clinic/Center | 20950 N Tatum Blvd, Suite 170, Phoenix, AZ 85050-4200 | 2017-01-19 |
| 1790141224 | Cheryl Schaaf | Registered Nurse | 20950 N Tatum Blvd, Suite 150, Phoenix, AZ 85050-4200 | 2016-01-13 |
| 1659749190 | Micheal Papademetriou | Dentist | 20950 N Tatum Blvd, 370, Phoenix, AZ 85050-4200 | 2015-09-14 |
| 1124427828 | Derrick A. Debenedetto | Physical Therapist | 20950 N Tatum Blvd, Ste. 100, Phoenix, AZ 85050-4200 | 2014-08-19 |
| 1770997413 | Kaitlyn Kakar | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2014-06-19 |
| 1568874683 | Az Pain Consultants LLC | Pain Medicine | 20950 N Tatum Blvd, Suite 220, Phoenix, AZ 85050-4200 | 2014-05-22 |
| 1215363320 | Desert Ridge Oral,facial & Implant Surgery, Pllc | Dentist | 20950 N Tatum Blvd, Suite 120, Phoenix, AZ 85050-4200 | 2013-09-20 |
| 1427490242 | Lauren K. Hasquet | Physical Therapist | 20950 N Tatum Blvd, Suite 100, Phoenix, AZ 85050-4200 | 2013-07-22 |
| 1508175019 | Kevin J Truitt | Physical Therapist | 20950 N Tatum Blvd, Suite100, Phoenix, AZ 85050-4200 | 2010-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770045528 | Jesse Micheal Stokke | Student in an Organized Health Care Education/Training Program | Honorhealth Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-04-02 |
| 1386104974 | Dania Aijaz Shah | Student in an Organized Health Care Education/Training Program | Honor Health Jomax Clinic, 26224 N. Tatum Blvd. #5, Phoenix, AZ 85050 | 2019-03-21 |
| 1205391588 | Sanctuary | Clinic/Center | 2550 E Rose Garden Ln, # 73404, Phoenix, AZ 85050 | 2019-01-31 |
| 1477026474 | Archer Health LLC | Nurse Practitioner | 21001 N Tatum Blvd Ste 1630 - 490, Phoenix, AZ 85050 | 2019-01-02 |
| 1548756059 | Preston Andrew Slade | Community/Behavioral Health | 20860 E. Tatum Blvd Ste, 300, Phoenix, AZ 85050 | 2018-07-09 |
| 1184126658 | Alisha Ramirez | Specialist/Technologist | 19638 N 37th Way, Phoenix, AZ 85050 | 2018-03-01 |
| 1720590011 | Dr Richards Pllc | Internal Medicine | 20815 N 25th Pl Ste A106, Phoenix, AZ 85050 | 2017-10-26 |
| 1417474792 | Heather Arabeity | Nurse Practitioner | 3762 E Zachary Dr, Phoenix, AZ 85050 | 2017-08-28 |
| 1083161087 | Haley Elaine Kinzer | Physician Assistant | 20950 N Tatum Blvd Ste 150, Phoenix, AZ 85050 | 2016-09-07 |
| 1003227927 | Chelsea Joy Thomsen | Internal Medicine | 26224 N Tatum Blvd Ste 7, Phoenix, AZ 85050 | 2014-05-13 |
| Find all providers in zip 85050 | ||||
| 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 |
|---|---|---|---|---|
| 1730681776 | Phoenix Oral and Maxillofacial Surgeons | Dentist | 9515 W Camelback Rd Ste 122, Phoenix, AZ 85037-1365 | 2018-03-06 |
| 1861993040 | Joseph E. Pierse, Dmd, Pllc | Dentist | 2060 W Whispering Wind Dr Ste 167, Phoenix, AZ 85085-2869 | 2018-02-23 |
| 1508253014 | Benjamin Noel Zuniga | Dentist | 3542 W Camelback Rd, Phoenix, AZ 85019 | 2015-04-22 |
| 1730450677 | Aria Dental Center LLC | Dentist | 12320 N 32nd St Ste 2, Phoenix, AZ 85032-7154 | 2012-01-24 |
| 1285873125 | An Elegant Smile P.C. | Dentist | 4550 E Bell Rd Ste 8-178, Phoenix, AZ 85032-9306 | 2009-02-17 |
| 1740486737 | Amogh Velangi | Dentist | 706 E Bell Rd Ste 106, Phoenix, AZ 85022-6641 | 2007-06-26 |
| 1568667061 | Oral & Facial Surgeons of Arizona | Dentist | 5050 N. 40th Street, Suite 180, Phoenix, AZ 85018 | 2007-06-15 |
| 1003038571 | Bogdan Michael Kulikowski | Dentist | 15215 S 48th Street, Suite #158, Phoenix, AZ 85044-9139 | 2007-05-03 |
| 1912121930 | Steven K. Ingersoll Dds PC | Dentist | 10211 N 32nd St Ste A1, Phoenix, AZ 85028-3841 | 2007-04-12 |
| 1144381468 | Reed H. Day | Dentist | 2222 E Highland Ave Ste 320, Phoenix, AZ 85016-4879 | 2006-12-12 |
| 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.