Healthcare Provider Details

I. General information

NPI: 1114071388
Provider Name (Legal Business Name): APEX ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 S LINDSAY RD STE. 127
GILBERT AZ
85296-6503
US

IV. Provider business mailing address

3303 S LINDSAY RD STE. 127
GILBERT AZ
85296-6503
US

V. Phone/Fax

Practice location:
  • Phone: 480-699-2940
  • Fax: 480-699-2941
Mailing address:
  • Phone: 480-699-2940
  • Fax: 480-699-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD5593
License Number StateAZ

VIII. Authorized Official

Name: DR. IKE HARDY
Title or Position: OWNER
Credential: DMD
Phone: 480-699-2940