Healthcare Provider Details

I. General information

NPI: 1760313829
Provider Name (Legal Business Name): JOSHUA FOSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 E MAIN ST
MESA AZ
85203-9024
US

IV. Provider business mailing address

784 S HAWK LN
GILBERT AZ
85296-0158
US

V. Phone/Fax

Practice location:
  • Phone: 480-729-6090
  • Fax:
Mailing address:
  • Phone: 801-300-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012804
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: