Healthcare Provider Details

I. General information

NPI: 1831414671
Provider Name (Legal Business Name): DR. CHAD R FOSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 W BELL RD STE 5
PHOENIX AZ
85053-2792
US

IV. Provider business mailing address

2028 E MYRNA LN
TEMPE AZ
85284-3508
US

V. Phone/Fax

Practice location:
  • Phone: 602-938-6709
  • Fax: 602-439-8485
Mailing address:
  • Phone: 714-337-8505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7956
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: