Healthcare Provider Details

I. General information

NPI: 1346831989
Provider Name (Legal Business Name): BOULDER CROSSINGS DENTAL PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4954 BOULDER HWY
LAS VEGAS NV
89121-3016
US

IV. Provider business mailing address

3030 N. CENTRAL AVE SUITE 1500
PHOENIX AZ
85012-2750
US

V. Phone/Fax

Practice location:
  • Phone: 702-847-6273
  • Fax: 702-847-6274
Mailing address:
  • Phone: 602-427-4066
  • Fax:

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 Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. WHITNEY WRIGHT
Title or Position: OFFICER
Credential: DDS
Phone: 480-339-4800