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NPI Code Detail

MEDICARE: ARIZONA DENTAL PROFESSIONALS, P.C.

MEDICARE: ARIZONA DENTAL PROFESSIONALS, P.C.
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1871440594
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARIZONA DENTAL PROFESSIONALS, P.C.
Provider Business Mailing Address
First Line : 2810 N SWAN RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85712-6300
Country : US
Telephone Number : 520-745-5496
Fax Number :
Provider Business Practice Location Address
First Line : 2810 N SWAN RD STE 100
Second Line :
City : TUCSON
State : AZ
Zip : 85712-6300
Country : US
Telephone Number : 520-745-5496
Fax Number :
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : HILLARY THULL
Credential :
Telephone Number : 217-540-8946
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/26/2026

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Directions to “ARIZONA DENTAL PROFESSIONALS, P.C. ” Practice Location

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