PACIFIC DENTAL SERVICES FOUNDATION (NPI# 1659848208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659848208 |
| Entity Type | Organization |
| Organization Name | PACIFIC DENTAL SERVICES FOUNDATION |
| Practice Address |
4559 E. Bell Road, Ste 106 Phoenix AZ 85032 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 7148458500 |
| Practice Fax Number | 3039520892 |
| Mailing Telephone | 7148458500 |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2019-03-28 |
| Authorized Official Name | JACK DILLENBERG (OWNER) |
| Authorized Official Telephone | 7148458500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| PDS Foundation Dentists for Special Needs | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Pacific Dental Services Foundation | 17000 Red Hill Avenue, Irvine, CA 92614 |
| North Carolina Corporations | Pacific Dental Services Foundation | 17000 Red Hill Avenue, Irvine, CA 92614 |
| Oregon Corporations, Companies and Business Names | PACIFIC DENTAL SERVICES FOUNDATION | 17000 Red Hill Ave, Irvine, CA 92614 |
| Washington State Corporations | PACIFIC DENTAL SERVICES FOUNDATION | 17000 Red Hill Ave, Irvine, CA 92614-5626 |
| Street Address |
4559 E. BELL ROAD, STE 106 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689298838 | Eboni Nicole Morris | Psychologist | 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 | 2020-06-03 |
| 1326688573 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3227 E Bell Road, Suite 170, Room P1, Phoenix, AZ 85032 | 2020-01-15 |
| 1740836642 | Integrated Medical Services Inc | Internal Medicine | 3815 W Bell Rd, Ste 3200, Phoenix, AZ 85032 | 2019-08-15 |
| 1639739576 | Sarah Martin | Physical Therapy Assistant | Ridgecrest Healthcare, 16640 North 38th Street, Phoenix, AZ 85032 | 2019-06-13 |
| 1750846168 | Conte Sport Performance Therapy LLC | Physical Therapist | 18413 N. Cave Creed Rd, Suite 8, Phoenix, AZ 85032 | 2019-02-11 |
| 1083100812 | Phoenix Interventional Pain Management, Pllc | Anesthesiology | 3815 E Bell Rd Ste 3500a, Phoenix, AZ 85032 | 2018-07-04 |
| 1770074635 | Np Professional LLC | Clinic/Center | 3329 E Bell Rd Ste A1, Phoenix, AZ 85032 | 2018-05-25 |
| 1932600020 | North Phoenix Asc LLC | Clinic/Center | 3329 E Bell Rd Ste A2-a5, Phoenix, AZ 85032 | 2018-02-23 |
| 1396263307 | Cheryl Anne Miller | Registered Nurse | 15002 N. 32nd St., Phoenix, AZ 85032 | 2017-08-30 |
| 1518480896 | Katherine Smith | Massage Therapist | 4242 E Cactus Rd, Apt 432, Phoenix, AZ 85032 | 2017-07-19 |
| Find all providers in zip 85032 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1124502372 | Amanda Rose Jones | Physician Assistant | 36427 N 14th St, Phoenix, AZ 85086-7506 | 2018-09-23 |
| 1639681745 | Martha Lopez | Physician Assistant | 7010 E Chauncey Ln Ste 210, Phoenix, AZ 85054-3115 | 2017-10-30 |
| 1386153674 | Emily Meredith Eoff | Physician Assistant | 301 W Pasadena Ave Apt 4, Phoenix, AZ 85013-2342 | 2017-09-29 |
| 1659890754 | Greg Horn | Physician Assistant | 20333 N 19th Ave Ste 230, Phoenix, AZ 85027-9901 | 2017-09-11 |
| 1619407269 | Integrative Natural Medicine | Physician Assistant | 2025 E Campbell Ave, #259, Phoenix, AZ 85016-8501 | 2017-06-15 |
| 1174996870 | Jyoti Sharma | Physician Assistant | 13838 S 46th Pl Ste 120, Phoenix, AZ 85044-7801 | 2015-11-04 |
| 1487025086 | Shaye Harrel | Physician Assistant | 9305 W Thomas Rd Ste 478, Phoenix, AZ 85037-3375 | 2015-10-08 |
| 1396114922 | Taylor Allison Lukas | Physician Assistant | 6005 N 10th Way, Phoenix, AZ 85014-1932 | 2015-09-24 |
| 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.