DR WISDOM TEETH (NPI# 1992298533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992298533 |
| Entity Type | Organization |
| Organization Name | DR WISDOM TEETH |
| Other Organization Name | DR WISDOM TEETH |
| Practice Address |
287 E Hunt Hwy Ste 101 San Tan Valley AZ 85143-5096 |
| Practice Telephone | 8333947366 |
| Mailing Telephone | 8333947366 |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |
| Authorized Official Name | DR. JEFFREY FENN (OWNER) |
| Authorized Official Telephone | 7023257627 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D009399 | AZ | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dr Wisdom Teeth | Doing Business As Name - Organization |
| Street Address |
287 E HUNT HWY STE 101 |
| City | SAN TAN VALLEY |
| State | AZ |
| Zip Code | 85143-5096 |
| 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 | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164075602 | Stauffer Whiting Dental, LLC | Clinic/Center | 36275 N Gantzel Rd Ste 100, San Tan Valley, AZ 85140-7319 | 2019-07-23 |
| 1467929448 | Gantzel Dental Center | Clinic/Center | 36327 N Gantzel Rd Ste 104, San Tan Valley, AZ 85140-7328 | 2018-10-29 |
| 1184159360 | Jrfdo LLC | Clinic/Center | 530 E Hunt Hwy Ste 123, San Tan Valley, AZ 85143-6583 | 2017-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063329 | Trombetta Dental Solutions | Clinic/Center | 13808 N Sandario Rd Ste 100, Marana, AZ 85653-8940 | 2020-11-06 |
| 1629676903 | Dental and Braces Dysart LLC | Clinic/Center | 1450 N Dysart Rd Ste A7, Avondale, AZ 85323-1534 | 2020-10-09 |
| 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 |
| 1699389510 | Ocotillo Dental Associates LLC | Clinic/Center | 11259 S Frontage Rd Ste 103, Yuma, AZ 85367-7883 | 2020-09-08 |
| 1144832940 | Kingman Dental Professionals, LLC | Clinic/Center | 3775 N Stockton Hill Rd, Kingman, AZ 86409-3219 | 2020-08-21 |
| 1336751536 | Smile Nuvo | Clinic/Center | 2142 W Red Fox Rd, Phoenix, AZ 85085-5458 | 2020-08-19 |
| 1396354205 | Freedom Dental, Pllc | Clinic/Center | 6328 E Brown Rd Ste 105, Mesa, AZ 85205-4841 | 2020-07-27 |
| 1649888629 | Whitney A Sebree, Dmd Pllc | Clinic/Center | 15331 W Bell Rd Ste 204, Surprise, AZ 85374-4104 | 2020-07-16 |
| 1912520347 | Dr. Reese Turner, Dds, PC | Clinic/Center | 9059 W Lake Pleasant Pkwy Ste A100, Peoria, AZ 85382-8393 | 2020-05-20 |
| 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 DR WISDOM TEETH.
| 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.