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General NPI Number Information
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NPI Number | 1538052295
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Entity Type | Individual
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Provider Name | KIAN TINGEY
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Gender | Male
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 8345 W THUNDERBIRD RD STE B100
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City | PEORIA
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State | AZ
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Zip | 85381-3668
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Country | US
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Telephone | 602-943-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 7022 W MAYA WAY
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City | PEORIA
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State | AZ
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Zip | 85383-5564
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Country | US
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Telephone | 425-985-6003
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D012512
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License Number State | AZ
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