=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952776858
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING DENTISTRY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2015
-----------------------------------------------------
Last Update Date | 12/03/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10615 N HAYDEN RD SUITE C-104
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85260-5734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-348-2273
-----------------------------------------------------
Fax | 480-991-0138
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1854
-----------------------------------------------------
City | LITCHFIELD PARK
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85340-1854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-348-2273
-----------------------------------------------------
Fax | 480-991-0138
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER MEMBER
-----------------------------------------------------
Name | DR. MICHAEL WASSEF
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 480-348-2273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number | D05171
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------