Healthcare Provider Details

I. General information

NPI: 1124232392
Provider Name (Legal Business Name): ARIZONA SUNSET DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 05/08/2023
Certification Date: 05/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 W ORANGE GROVE RD SUITE 206
TUCSON AZ
85704-1139
US

IV. Provider business mailing address

2205 W MAGEE RD STE 124
TUCSON AZ
85742-4312
US

V. Phone/Fax

Practice location:
  • Phone: 520-797-4551
  • Fax: 520-797-8005
Mailing address:
  • Phone: 520-797-4551
  • Fax: 520-797-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number4364
License Number StateAZ

VIII. Authorized Official

Name: DR. JOSE ANTONIO OSETE
Title or Position: PRESIDENT
Credential: DDS
Phone: 520-797-4551