SANTAN KIDTASTIC LLC (NPI# 1669726030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669726030 |
| Entity Type | Organization |
| Organization Name | SANTAN KIDTASTIC LLC |
| Other Organization Name | SANTAN KIDTASTICS |
| Practice Address |
2510 E Hunt Hwy Ste 29 San Tan Valley AZ 85143-5208 |
| Mailing Address |
4704 E Southern Ave Mesa AZ 85206-2737 |
| Practice Telephone | 4806484037 |
| Practice Fax Number | 4806965505 |
| Mailing Telephone | 4806484037 |
| Mailing Fax Number | 4806965505 |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2013-12-06 |
| Authorized Official Name | MS. JAIME JOHNSON (CONTROLL) |
| Authorized Official Telephone | 4806484037 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| SanTan Kidtastics | Doing Business As Name - Organization |
| Street Address |
2510 E HUNT HWY STE 29 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85143-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558902247 | Stan Kidtastic Dental LLC | Dentist | 2510 E Hunt Hwy Ste 29, San Tan Valley, AZ 85143-5208 | 2019-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619457785 | Shalom Behavioral Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35301 N Belgian Blue Ct, San Tan Valley, AZ 85143 | 2018-08-18 |
| 1336662337 | House of Dignity Assisted Living LLC | Assisted Living Facility | 214 W Danish Red Trl, San Tan Valley, AZ 85143 | 2017-07-21 |
| 1942744081 | Arizona Dental Professionals, PC | Dentist | 545 E Hunt Hwy, San Tan Valley, AZ 85143 | 2016-12-08 |
| 1285000786 | Jared Scott Snyder | Physical Therapy Assistant | 1745 E Hunt Hwy, Suite 103, San Tan Valley, AZ 85143 | 2015-08-19 |
| 1801289236 | Tiffany Battle | Behavioral Analyst | 2626 E. Manuel Road, San Tan Valley, AZ 85143 | 2015-03-10 |
| 1437541091 | Kelly Denise Griffin | Registered Nurse | 35945 N. Gary Rd, Suite 101, San Tan Valley, AZ 85143 | 2015-02-19 |
| 1528496031 | Casey Manzanedo | Licensed Practical Nurse | 35900 E Charbray Dr., San Tan Valley, AZ 85143 | 2013-10-18 |
| 1891136461 | Lisa Kay Scarpa | Home Health Aide | 925 E Canyon Rock Rd, San Tan Valley, AZ 85143 | 2013-07-11 |
| 1790969426 | Emilia Elizabeth Gomez Vieytez | Pediatrics | 22707 S. Ellsworth Rd H 101, Queen Creek, AZ 85143 | 2007-12-17 |
| 1205814621 | Janet F Rinehart | Family Medicine | 30046 N Varnum Rd, San Tan Valley, AZ 85143 | 2006-01-05 |
| Find all providers in zip 85143 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558902247 | Stan Kidtastic Dental LLC | Dentist | 2510 E Hunt Hwy Ste 29, San Tan Valley, AZ 85143-5208 | 2019-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881206274 | Totally Kids Dental P.C. | Dentist | 602 W Union Hills Dr Ste 9, Phoenix, AZ 85027-6629 | 2020-08-18 |
| 1033750724 | Mesa Valley Dental LLC | Dentist | 1220 S Higley Rd Ste 206, Mesa, AZ 85206-4002 | 2019-10-03 |
| 1942841663 | Mesa Kidtastic Dental LLC | Dentist | 1240 W Southern Ave Ste 112, Mesa, AZ 85202-4882 | 2019-10-03 |
| 1497396170 | Gilbert Kidtastic Dental LLC | Dentist | 3303 E Queen Creek Rd Ste 106, Gilbert, AZ 85297-8532 | 2019-10-03 |
| 1386207785 | Cattron's Dmd, Pllc | Dentist | 4024 E Guadalupe Rd Ste 105, Gilbert, AZ 85234-7672 | 2019-04-21 |
| 1578126470 | Scottsdale Pediatric Dental Associates Inc | Dentist | 9280 E Raintree, Suite 108, Scottsdale, AZ 85260 | 2019-04-16 |
| 1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
| 1568957199 | Maureen Malingkas | Dentist | 8248 W Deer Valley Rd, Peoria, AZ 85382-2198 | 2018-06-26 |
| 1407344567 | Kids Dental Group Pllc | Dentist | 6239 E Brown Rd Ste 102, Mesa, AZ 85205-4933 | 2018-04-24 |
| 1861989121 | Logan Mariano | Dentist | 4383 E Rosemonte Dr, Phoenix, AZ 85050-3407 | 2018-04-21 |
| Find all providers with the same taxonomy | ||||
| City | SAN TAN VALLEY |
| Zip Code | 85143 |
Please comment or provide details below to improve the information on SANTAN KIDTASTIC LLC.
| 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.