Healthcare Provider Details

I. General information

NPI: 1861316473
Provider Name (Legal Business Name): OCOTILLO DENTISTRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S ALMA SCHOOL RD STE 103
CHANDLER AZ
85248-3755
US

IV. Provider business mailing address

1142 W SUNRISE PL
CHANDLER AZ
85248-3739
US

V. Phone/Fax

Practice location:
  • Phone: 480-818-5570
  • Fax:
Mailing address:
  • Phone: 602-540-8808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEANNE MEIER
Title or Position: OWNER
Credential:
Phone: 602-540-8808