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General NPI Number Information
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NPI Number | 1396061453
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Entity Type | Individual
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Provider Name | JAY WRIGHT DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 7757 W DEER VALLEY RD STE 260
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City | PEORIA
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State | AZ
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Zip | 85382-2118
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Country | US
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Telephone | 602-284-5163
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Fax | 623-444-4822
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Provider Business Mailing Address
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Address Line | 5505 W BUCKSKIN TRL
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City | PHOENIX
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State | AZ
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Zip | 85083-4302
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Country | US
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Telephone | 951-551-3733
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Fax | 866-479-2701
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30856
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4975
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License Number State | AZ
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