National Provider Identifier Database

CENTRAL AVENUE SPECIALTY PLLC
Endodontics

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.


Contact Information

CENTRAL AVENUE SPECIALTY, PLLC.
5133 N CENTRAL AVE
SUITE 200
PHOENIX, AZ85012-1438
Phone: 602-266-1776
Fax: 602-234-1814
Website:
Specialty Taxonomy Code
* Endodontics 1223E0200X
Pediatric Dentistry 1223P0221X
Prosthodontics 1223P0700X

* Indicates primary specialty

NPI Profile & details for CENTRAL AVENUE SPECIALTY, PLLC.

NPI Number 1104257963
Legal business name
LBN
CENTRAL AVENUE SPECIALTY, PLLC.
Authorized official ANTHONY HERRO - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 12/04/2013
Last updated 12/04/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: D008035
  • AZ License #: D008106
  • AZ License #: D07259

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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