MEDICARE: DENVER SOUTH DENTAL PARTNERS PLLC

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	122300000X	Dentist	D8182	AZ

General Provider Information

NPI Number	:	1114350402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER SOUTH DENTAL PARTNERS PLLC

Provider Business Mailing Address
First Line	:	3030 NORTH CENTRAL AVENUE, SUITE 1500
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012
Country	:	US
Telephone Number	:	480-339-4800
Fax Number	:	480-339-4812

Provider Business Practice Location Address
First Line	:	2731 WEST EVANS AVENUE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219
Country	:	US
Telephone Number	:	720-636-9828
Fax Number	:	480-339-4812

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WHITNEY WRIGHT
Credential	:	DDS
Telephone Number	:	602-489-0298

Provider Enumeration Date	:	08/09/2013
Last Update Date	:	12/15/2020

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