Healthcare Provider Details

I. General information

NPI: 1700409166
Provider Name (Legal Business Name): PAVEL DUBINETSKY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 W GERMANN RD STE 4
CHANDLER AZ
85286-8457
US

IV. Provider business mailing address

1960 W GERMANN RD STE 4
CHANDLER AZ
85286-8457
US

V. Phone/Fax

Practice location:
  • Phone: 480-334-5402
  • Fax: 480-808-5595
Mailing address:
  • Phone: 480-334-5402
  • Fax: 480-808-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD010923
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: