Healthcare Provider Details

I. General information

NPI: 1114350402
Provider Name (Legal Business Name): DENVER SOUTH DENTAL PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 WEST EVANS AVENUE
DENVER CO
80219
US

IV. Provider business mailing address

3030 NORTH CENTRAL AVENUE, SUITE 1500
PHOENIX AZ
85012
US

V. Phone/Fax

Practice location:
  • Phone: 720-636-9828
  • Fax: 480-339-4812
Mailing address:
  • Phone: 480-339-4800
  • Fax: 480-339-4812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD8182
License Number StateAZ

VIII. Authorized Official

Name: DR. WHITNEY WRIGHT
Title or Position: OWNER
Credential: DDS
Phone: 602-489-0298