BLACK CANYON CITY DENTISTRY LLC (NPI# 1639380363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639380363 |
| Entity Type | Organization |
| Organization Name | BLACK CANYON CITY DENTISTRY LLC |
| Practice Address |
34501 S Old Black Canyon City Highway Suite 5 Black Canyon City AZ 85324 |
| Mailing Address |
Po Box #7 Black Canyon City AZ 85324 |
| Practice Telephone | 6233740855 |
| Practice Fax Number | 6233740854 |
| Mailing Telephone | 6233740855 |
| Mailing Fax Number | 6233740854 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ELDON W JENKINS (OWNER) |
| Authorized Official Telephone | 6233740855 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 05797 | AZ | Dental Providers |
| Street Address |
34501 S OLD BLACK CANYON CITY HIGHWAY SUITE 5 |
| City | BLACK CANYON CITY |
| State | AZ |
| Zip Code | 85324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356834642 | Canyon Medical Clinic LLC | Family Medicine | 34501 S Old Black Canyon Hwy # 1, Black Canyon City, AZ 85324 | 2018-06-11 |
| 1356708655 | Home Health Services, Pllc | Clinic/Center | 19375 E. Oasis, Black Canyon City, AZ 85324 | 2016-01-19 |
| 1760669600 | Emd Medical Services LLC | Clinic/Center | 18850 E. Schoolhouse Road, Black Canyon City, AZ 85324 | 2008-01-22 |
| 1477622405 | Kevin Carl Krause | Chiropractor | 34501 South Black Canyon Highway, Suite #3, Black Canyon City, AZ 85324 | 2006-11-06 |
| 1982669552 | Joshua Cheol-hong Kim | Internal Medicine | 34601 S. Phyllis St., Black Cayon City, AZ 85324 | 2006-04-18 |
| 1508079518 | Canon Elementary School District | Local Education Agency (LEA) | 34630 S School Loop Rd., Black Canyon City, AZ 85324-0089 | 2007-05-07 |
| 1265538474 | Marci Brown-gilpin | Counselor | 18850 E School House Rd, 3, Black Canyon City, AZ 85324-8787 | 2006-09-15 |
| 1669087599 | Heidi Marie Nida-huff | Nurse Practitioner | 19251 E Oasis Dr # 19251, Black Canyon City, AZ 85324-8878 | 2020-09-08 |
| 1467432971 | Randy Charles Hancock | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2006-01-19 |
| 1033690169 | Preventative Dental Care Pllc | Clinic/Center | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2018-08-27 |
| Find all providers in zip 85324 | ||||
| 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 |
|---|---|---|---|---|
| 1407456031 | Roger Ryan Roybal, Dds, Pllc | Dentist | 14300 N Northsight Blvd Ste 214, Scottsdale, AZ 85260-3677 | 2020-11-01 |
| 1851990444 | Shaveta Behl | Dentist | 320 E Mcdowell Rd Ste 221, Phoenix, AZ 85004-4516 | 2020-10-23 |
| 1083212575 | Rasha Adil Abduljabbar Al-kaabi | Dentist | 4750 E Union Hills Dr Apt 1076, Phoenix, AZ 85050-3366 | 2020-10-15 |
| 1124625793 | Gilbert Crossroads Kids' Dentists and Orthodontics, LLP | Dentist | 835 S. Gilbert Rd, Suite 104, Gilbert, AZ 85296 | 2020-10-06 |
| 1750998969 | Christie Jacques | Dentist | 7410 E Sutton Dr, Scottsdale, AZ 85260-3915 | 2020-09-30 |
| 1447865480 | Luke Michael Mangelsdorf | Dentist | 2249 Hualapai Mountain Rd Ste 1, Kingman, AZ 86401-8321 | 2020-09-15 |
| 1386258689 | Joshua Dutton | Dentist | 8325 W Happy Valley Rd Unit 100, Peoria, AZ 85383-4361 | 2020-09-03 |
| 1912510678 | Nicholas Ahn | Dentist | 1550 E Campbell Ave Apt 3028, Phoenix, AZ 85014-4271 | 2020-08-24 |
| 1992317143 | Justin S Dole | Dentist | 15125 N Scottsdale Rd Apt 303, Scottsdale, AZ 85254-3157 | 2020-08-19 |
| 1326659087 | Triple Eight Dental Group, Pllc | Dentist | 7910 W Thomas Rd Ste 118, Phoenix, AZ 85033-4830 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
| City | BLACK CANYON CITY |
| Zip Code | 85324 |
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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.