Desert Ridge Pediatric Dentistry in Phoenix - Dental
Desert Ridge Pediatric Dentistry - NPI 1811176860
Desert Ridge Pediatric Dentistry is a Dental in Phoenix, Arizona. Desert Ridge Pediatric Dentistry practices all healthcare services and medical treatments related to Dental. The NPI Number for Desert Ridge Pediatric Dentistry is 1811176860. The last update date is 2015-07-17.
Desert Ridge Pediatric Dentistry's current location address is 5315 E High St, Phoenix, Arizona. You can contact this provider via phone number 4805855868 and fax number 4805851208. The mailing address for Desert Ridge Pediatric Dentistry is 5315 E High St, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Desert Ridge Pediatric Dentistry |
|---|---|
| Address | 5315 E High St, Phoenix, Arizona |
| Phone Number | 4805855868 |
| Fax Number | 4805851208 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Libby R Lidieth |
| Credentials | D.D.S. |
| Telephone Number | 4805855868 |
NPI Number Detail
| NPI Number | 1811176860 |
|---|---|
| Provider Enumeration Date | 2007-10-26 |
| Last Updated Date | 2015-07-17 |
Provider Mailing Address Detail
| Address | 5315 E High St |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850545438 |
| Phone Number | 4805855868 |
| Fax Number | 4805851208 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 5548 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 632481 | AZ | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Desert Ridge Pediatric Dentistry by the Centers for Medicare & Medicaid Services?
The Desert Ridge Pediatric Dentistry has been issued the NPI (National Provider Identifier) 1811176860, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Desert Ridge Pediatric Dentistry located?
The Desert Ridge Pediatric Dentistry is located at 5315 E High St, Phoenix, AZ 850545438.
What is Desert Ridge Pediatric Dentistry's specialized field of practice, and what is the corresponding taxonomy classification code?
The Desert Ridge Pediatric Dentistry's area of specialization is Dental, and the corresponding taxonomy code that categorizes this field of practice is 261Qd0000X.
When did Desert Ridge Pediatric Dentistry receive its 1811176860 assignment?
The Desert Ridge Pediatric Dentistry was assigned its 1811176860 on 2007-10-26, which is the date when this unique identifier was issued to the organization.
As of what date were the Desert Ridge Pediatric Dentistry's details last updated?
The information pertaining to the Desert Ridge Pediatric Dentistry, including its address, specialty, and other details, was most recently updated on 2015-07-17.
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