=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285112292
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALPERS FAMILY AND COSMETIC DENTISTRY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2018
-----------------------------------------------------
Last Update Date | 08/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7500 E MCDONALD DR STE 101B
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85250-6000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-998-3355
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7500 E MCDONALD DR STE 101B
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85250-6000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-998-3355
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KRISTOPHER ROBERT ALPERS
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 480-208-3332
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | 8976
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------