MEDICARE: MESA DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4000	AZ

General Provider Information

NPI Number	:	1043297393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESA DENTAL CARE

Provider Business Mailing Address
First Line	:	1930 S DOBSON
Second Line	:	#1
City	:	MESA
State	:	AZ
Zip	:	85202
Country	:	US
Telephone Number	:	480-730-0500
Fax Number	:	480-730-0525

Provider Business Practice Location Address
First Line	:	1930 S DOBSON RD
Second Line	:	#1
City	:	MESA
State	:	AZ
Zip	:	85202
Country	:	US
Telephone Number	:	480-730-0500
Fax Number	:	480-730-0525

Authorized Official
Title or Position	:	OWNER
Name	:	ALI H NIA
Credential	:	DMD
Telephone Number	:	480-730-0500

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1144933565 — REYNA MARIA GRACIA-ESPINOZA
Practice Location Address:

2266 S DOBSON RD STE 200
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Practice Fax:

1891282042 — EMILY NACLERIO MD
Practice Location Address:

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1154299014 — MS. KYLA MARIE CHAVEZ PA-C
Practice Location Address:

1500 S DOBSON RD STE 202
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1588510085 — CHARIS WELLNESS, LLC
Practice Location Address:

2909 S DOBSON RD STE 14
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Practice Fax:

1821941188 — LAUREN FAITH FORBES
Practice Location Address:

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1932102977 — NABIN SHARMA M.D.
Practice Location Address:

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1215930581 — UNITED RESPIRATORY SERVICES, LLC
Practice Location Address:

2330 W BROADWAY RD , STE 112
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Practice Phone: 480-830-7700
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Directions to “MESA DENTAL CARE ” Practice Location

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