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NPI Code Detail

MEDICARE: DHHS-PHS, IHS TUCSON AREA, IHS TUCSON

MEDICARE: DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
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
11223P0221XPediatric Dentistry
2124Q00000XDental Hygienist
3126800000XDental Assistant
41223D0001XPublic Health Dentistry

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10325678OTHERAZNACADP#
2AZ0209600OTHERAZBC/BSAZ DENTAL PROV NO
303D0864297OTHERAZCLIA #
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215910484
Entity Type Code : Organization
Provider Name (Legal Business Name) : DHHS-PHS, IHS TUCSON AREA, IHS TUCSON
Provider Business Mailing Address
First Line : 7900 S J STOCK RD
Second Line :
City : TUCSON
State : AZ
Zip : 85746-7012
Country : US
Telephone Number : 520-295-2503
Fax Number : 520-295-2676
Provider Business Practice Location Address
First Line : 7900 S J STOCK RD
Second Line :
City : TUCSON
State : AZ
Zip : 85746-7012
Country : US
Telephone Number : 520-295-2575
Fax Number : 520-295-2574
Authorized Official
Title or Position : BUDGET ANALYST
Name : MS. ARLENE RAYMOND
Credential :
Telephone Number : 520-295-2427
Provider Enumeration Date : 11/22/2005
Last Update Date : 04/22/2008

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Directions to “DHHS-PHS, IHS TUCSON AREA, IHS TUCSON ” Practice Location

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