Healthcare Provider Details

I. General information

NPI: 1174726400
Provider Name (Legal Business Name): JOAN FOX DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10827 S 51 STREET #205
PHX AZ
85044
US

IV. Provider business mailing address

10827 S 51 STREET #205
PHX AZ
85044
US

V. Phone/Fax

Practice location:
  • Phone: 480-893-1780
  • Fax:
Mailing address:
  • Phone: 480-893-1780
  • Fax: 480-893-3424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD4274
License Number StateAZ

VIII. Authorized Official

Name: DR. JOAN FOX
Title or Position: PRESIDENT
Credential: DDS PC
Phone: 480-893-1780