Healthcare Provider Details

I. General information

NPI: 1205351392
Provider Name (Legal Business Name): ARCADIA PEDIATRIC DENTISTRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5717 E THOMAS RD STE 110
SCOTTSDALE AZ
85251-7620
US

IV. Provider business mailing address

5717 E THOMAS RD STE 110
SCOTTSDALE AZ
85251-7620
US

V. Phone/Fax

Practice location:
  • Phone: 480-207-5070
  • Fax: 480-304-3005
Mailing address:
  • Phone: 480-207-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERESA ZWICKY
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 480-866-8811