MEDICARE: C AND E DENTAL PROFESSIONALS 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	261QD0000X	Dental Clinic/Center
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1437613825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C AND E DENTAL PROFESSIONALS PLLC

Provider Business Mailing Address
First Line	:	13821 N 35TH DR STE 2
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5541
Country	:	US
Telephone Number	:	602-547-9007
Fax Number	:

Provider Business Practice Location Address
First Line	:	13821 N 35TH DR STE 2
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-5541
Country	:	US
Telephone Number	:	602-882-0676
Fax Number	:	602-547-3438

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DEBORAH BONNET
Credential	:
Telephone Number	:	602-882-0676

Provider Enumeration Date	:	01/30/2019
Last Update Date	:	12/12/2025

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