Healthcare Provider Details

I. General information

NPI: 1316022171
Provider Name (Legal Business Name): TRU-VALUE DENTURE AND DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 E UNIVERSITY DR
MESA AZ
85203-8210
US

IV. Provider business mailing address

1722 E UNIVERSITY DR
MESA AZ
85203-8210
US

V. Phone/Fax

Practice location:
  • Phone: 480-833-9942
  • Fax: 480-833-6160
Mailing address:
  • Phone: 480-833-9942
  • Fax: 480-833-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code292200000X
TaxonomyDental Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD Y KHALIFE
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 480-833-9942