BANNER MEDICAL GROUP DENTAL SERVICES LLC (NPI# 1770953598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770953598 |
| Entity Type | Organization |
| Organization Name | BANNER MEDICAL GROUP DENTAL SERVICES LLC |
| Practice Address |
1111 E Mcdowell Rd Phoenix AZ 85006-2612 |
| Mailing Address |
2901 N Central Ave Phoenix AZ 85012-2700 |
| Practice Telephone | 6028392000 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |
| Authorized Official Name | DENNIS DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER MEDICAL GROUP DENTAL SERVICES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Street Address |
1111 E MCDOWELL RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85006-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255334785 | Todd Brian Taylor | Emergency Medicine | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2005-05-30 |
| 1912507609 | Kelsey Arndt | Dietitian, Registered | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-10-30 |
| 1518567403 | Emily Truex | Nurse Practitioner | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-10-29 |
| 1306445002 | Sina Lee Heller | Registered Nurse | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-10-22 |
| 1215549985 | Aishwarya Puri | Student in an Organized Health Care Education/Training Program | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-08-23 |
| 1437761038 | Lee Daniel Reeves-blurton | Registered Nurse | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-08-17 |
| 1295358414 | Shaida Omid | Student in an Organized Health Care Education/Training Program | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-05-21 |
| 1831712157 | Hija Mae Bautista | Nurse Practitioner | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-05-20 |
| 1164042206 | Arati Babaria Pandya | Student in an Organized Health Care Education/Training Program | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-04-18 |
| 1275153595 | Chirag Vinay Kapadia | Student in an Organized Health Care Education/Training Program | 1111 E Mcdowell Rd, Phoenix, AZ 85006-2612 | 2020-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
| 1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
| 1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
| 1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
| 1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
| Find all providers in zip 85006 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255946257 | Tatum Point Dentistry LLC | Clinic/Center | 4747 E Bell Rd Ste 15, Phoenix, AZ 85032-2301 | 2020-09-15 |
| 1003421009 | Solterra Dentistry LLC | Clinic/Center | 15255 N 40th St Ste 111, Phoenix, AZ 85032-4636 | 2020-09-15 |
| 1336751536 | Smile Nuvo | Clinic/Center | 2142 W Red Fox Rd, Phoenix, AZ 85085-5458 | 2020-08-19 |
| 1942821301 | Family and Kids Dental LLC | Clinic/Center | 2610 W Baseline Rd Ste 120, Phoenix, AZ 85041-6400 | 2020-04-27 |
| 1003458688 | Uptown Pediatric Dental Group, Pllc | Clinic/Center | 1515 E Missouri Ave Ste 103, Phoenix, AZ 85014-2443 | 2019-10-15 |
| 1538720818 | Scott A. Simpson Dds Pllc | Clinic/Center | 14231 N 7th St Ste A14231n7, Phoenix, AZ 85022-4360 | 2019-06-26 |
| 1992362891 | Lemon Tree Dentistry LLC | Clinic/Center | 1985 W Happy Valley Rd Ste 115, Phoenix, AZ 85085-2888 | 2019-05-26 |
| 1457813768 | Singh Smile Care | Clinic/Center | 3201 W Peoria Ave Ste A103, Phoenix, AZ 85029-4609 | 2019-04-04 |
| 1710447370 | Minted Dental | Clinic/Center | 21050 N Tatum Blvd Ste 200, Phoenix, AZ 85050-4262 | 2019-03-20 |
| 1679032197 | Denkha Dentistry, LLC | Clinic/Center | 1601 E Bell Rd Ste A13, Phoenix, AZ 85022-6254 | 2019-03-14 |
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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.