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Contact Information

SOUTHERN DENTAL
3320 W. SOUTHERN AVENUE
SUITE # 108
PHOENIX, AZ85041
 Phone: 602-305-8800
 Fax: 602-305-8801
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SOUTHERN DENTAL

NPI Number 1265616213
LBN Legal business name SOUTHERN DENTAL
Authorized official PETER NGUYEN - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/27/2007
Last updated 12/27/2007 - About 18 years ago
Identifiers
AZ License # 5995
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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