NPI Code Detail JSON Logo

1205270386 NPI number — PHOENIX ORTHODONTICS LLC

NPI Number: 1205270386
Health Care Provider/Practitioner: PHOENIX ORTHODONTICS LLC

Information about “1205270386” NPI (PHOENIX ORTHODONTICS LLC) exists in 1205270386 in HTML format HTML  |  1205270386 in plain Text format TXT  |  1205270386 in PDF (Portable Document Format) PDF  |  1205270386 in an XML format XML  formats.

NPI Number : 1205270386 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205270386",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PHOENIX ORTHODONTICS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6750 N 19TH AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85015-1127",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-242-5741",
    "MailingAddressFaxNumber": "602-242-5742",
    "FirstLinePracticeLocationAddress": "6750 N 19TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHOENIX",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85015-1127",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-242-5741",
    "PracticeLocationAddressFaxNumber": "602-242-5742",
    "EnumerationDate": "04/19/2013",
    "LastUpdateDate": "04/19/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALLMENDINGER",
    "AuthorizedOfficialFirstName": "BRIAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "602-242-5741",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223X0400X",
        "TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
        "LicenseNumber": "D5273",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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