MEDICARE: ARCADIA AZ DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1922787654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADIA AZ DENTISTRY

Provider Business Mailing Address
First Line	:	3409 N 56TH ST STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-6150
Country	:	US
Telephone Number	:	480-363-2145
Fax Number	:	480-994-9439

Provider Business Practice Location Address
First Line	:	3409 N 56TH ST STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-6150
Country	:	US
Telephone Number	:	480-994-5557
Fax Number	:	480-994-9439

Authorized Official
Title or Position	:	REGIONA MANAGER
Name	:	MRS. LETICIA ROJAS
Credential	:
Telephone Number	:	480-363-2145

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	08/28/2023

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Directions to “ARCADIA AZ DENTISTRY ” Practice Location

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