DENTAL AND BRACES MARYVALE LLC (NPI# 1871058891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871058891 |
Entity Type | Organization |
Organization Name | DENTAL AND BRACES MARYVALE LLC |
Practice Address |
6702 W Camelback Rd Ste 100 Glendale AZ 85303-6324 |
Mailing Address |
1515 N Gilbert Rd Ste 107-131 Gilbert AZ 85234-2318 |
Practice Telephone | 6026357450 |
Mailing Telephone | 6027148203 |
Enumeration Date | 2019-02-04 |
Last Update Date | 2019-02-04 |
Authorized Official Name | LIZ RAMOS (MANAGER) |
Authorized Official Telephone | 6027148203 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GENERAL DENTAL OFFICE | 12740016 | 01 |
Street Address |
6702 W CAMELBACK RD STE 100 |
City | GLENDALE |
State | AZ |
Zip Code | 85303-6324 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134727449 | Alexander Eric Smith | Dentist | 6702 W Camelback Rd Ste 100, Glendale, AZ 85303-6324 | 2020-10-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962050138 | Karina Navarrete | Specialist/Technologist | 7418 W. Fleetwood Ln, Glendale, AZ 85303 | 2019-08-29 |
1043733280 | Ainsley P. Vergara | Speech-Language Pathologist | 7355 W Orangewood Ave, Glendale, AZ 85303 | 2017-07-19 |
1043688492 | Karina Sosa | Specialist/Technologist | 7829 W San Miguel Avenue, Glendale, AZ 85303 | 2015-09-02 |
1437546462 | Westwind Dental Glendale, Pllc | Dentist | 6740 W Camelback Road, Glendale, AZ 85303 | 2015-04-16 |
1336498906 | Revival Home Care | Assisted Living Facility | 8269 W State Ave, Glendale, AZ 85303 | 2012-08-29 |
1700153707 | Habiitation and Independant Living Inc | Nursing Care | 7304 N 82nd Ave, Glendale, AZ 85303 | 2011-11-19 |
1225160658 | Kristy Beth Malecki | Speech-Language Pathologist | 7355 W Orangewood, Desert Spirit School, Glendale, AZ 85303 | 2007-03-12 |
1104980325 | Sharon Yvonne Thompson | Technician | 7384 W Colter St, Glendale, AZ 85303 | 2006-12-21 |
1447772264 | Bob Kabamba | Behavior Technician | 7136 N 73rd Dr, Gendale, AZ 85303 | 2017-07-13 |
1427420504 | Quick Med Center LLC | Family Medicine | 5104 N 67th Ave, Glendale, AZ 85303 | 2015-10-28 |
Find all providers in zip 85303 |
Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
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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.