MEDICARE: ISLAND DENTAL

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	AZ5662	AZ

General Provider Information

NPI Number	:	1780880880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND DENTAL

Provider Business Mailing Address
First Line	:	1489 W ELLIOT RD STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-5168
Country	:	US
Telephone Number	:	480-507-9400
Fax Number	:	480-507-9474

Provider Business Practice Location Address
First Line	:	1489 W ELLIOT RD STE 101
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-5168
Country	:	US
Telephone Number	:	480-507-9400
Fax Number	:	480-507-9474

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LYDE JEFFERSON ADAMS
Credential	:	DDS
Telephone Number	:	480-507-9400

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1952090938 — RESTORED COUNSELING & WELLNESS CENTER, PLLC
Practice Location Address:

1489 W ELLIOT RD STE 103
GILBERT, AZ
85233-5168

Practice Phone: 480-256-2829
Practice Fax:

1295819514 — MR. LYDE J ADAMS DDS
Practice Location Address:

1489 W ELLIOT RD STE 101
GILBERT, AZ
85233-5168

Practice Phone: 480-507-9400
Practice Fax:

1669658233 — N. PATEL DDS, PLLC
Practice Location Address:

1489 W ELLIOT RD STE 101
GILBERT, AZ
85233-5168

Practice Phone: 480-507-9400
Practice Fax: 480-507-9474

1699933317 — DR. NAMAN BHAILAL PATEL DDS
Practice Location Address:

1489 W ELLIOT RD , SUITE 101
GILBERT, AZ
85233-5168

Practice Phone: 480-507-9400
Practice Fax: 480-507-9474

1639846165 — ELLIOT ROAD DENTAL - ISLAND PLLC
Practice Location Address:

1489 W ELLIOT RD STE 101
GILBERT, AZ
85233-5168

Practice Phone: 480-507-9400
Practice Fax:

1538838172 — DR. KEELY PUCHALSKI ND
Practice Location Address:

1489 W ELLIOT RD STE 103
GILBERT, AZ
85233-5168

Practice Phone: 480-256-2999
Practice Fax: 480-520-4050

Directions to “ISLAND DENTAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.