Healthcare Provider Details
I. General information
NPI: 1144427022
Provider Name (Legal Business Name): MICHAEL S. CAVENDER, D.D.S.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8765 E BELL RD STE 213
SCOTTSDALE AZ
85260-1321
US
IV. Provider business mailing address
8765 E BELL RD STE 213
SCOTTSDALE AZ
85260-1321
US
V. Phone/Fax
- Phone: 480-731-3636
- Fax: 480-731-3637
- Phone: 480-731-3636
- Fax: 480-731-3637
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | 6872 |
| License Number State | AZ |
VIII. Authorized Official
Name: DR.
MICHAEL
S.
CAVENDER
Title or Position: DENTIST
Credential: D.D.S.
Phone: 480-731-3636