MEDICARE: BIPAR FAMILY 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1528993318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIPAR FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	4611 E SHEA BLVD STE 150
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-4256
Country	:	US
Telephone Number	:	602-494-1448
Fax Number	:	602-825-1654

Provider Business Practice Location Address
First Line	:	4611 E SHEA BLVD STE 150
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85028-4256
Country	:	US
Telephone Number	:	602-494-1448
Fax Number	:	602-825-1654

Authorized Official
Title or Position	:	ASSISTANT OFFICE MANAGER
Name	:	MRS. MICHELLE WHEELER SHERIDAN
Credential	:
Telephone Number	:	602-494-1448

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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