Healthcare Provider Details

I. General information

NPI: 1215327507
Provider Name (Legal Business Name): KERR ENDODONTICS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 S HIGLEY RD SUITE 116
GILBERT AZ
85296-4799
US

IV. Provider business mailing address

1355 S HIGLEY RD STE 116
GILBERT AZ
85296-4789
US

V. Phone/Fax

Practice location:
  • Phone: 480-545-4120
  • Fax: 480-545-4123
Mailing address:
  • Phone: 480-545-4120
  • Fax: 480-545-4123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X2210X
TaxonomyOrofacial Pain Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK A KERR
Title or Position: PRESIDENT
Credential: DDS
Phone: 480-545-4120