MEDICARE: DEER VALLEY DENTISTRY

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		AZ

General Provider Information

NPI Number	:	1396897534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEER VALLEY DENTISTRY

Provider Business Mailing Address
First Line	:	4235 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5343
Country	:	US
Telephone Number	:	602-843-2518
Fax Number	:	602-843-2303

Provider Business Practice Location Address
First Line	:	4235 W THUNDERBIRD RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5343
Country	:	US
Telephone Number	:	602-843-2518
Fax Number	:	602-843-2303

Authorized Official
Title or Position	:	DENTIST
Name	:	MR. JAY HAROLD SPIEGEL
Credential	:	D.D.S.
Telephone Number	:	602-843-2518

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/21/2022

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Directions to “DEER VALLEY DENTISTRY ” Practice Location

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