Healthcare Provider Details

I. General information

NPI: 1134056716
Provider Name (Legal Business Name): WEST VALLEY SMILE CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15128 W BELL RD STE 12
SURPRISE AZ
85374-2451
US

IV. Provider business mailing address

17246 W MEGHAN DR
GOODYEAR AZ
85338-1799
US

V. Phone/Fax

Practice location:
  • Phone: 623-250-6771
  • Fax: 623-250-6773
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BELEMA NGOZI OGBANGA-FARINAS
Title or Position: OWNER/OPERATOR
Credential: DMD
Phone: 623-698-4493