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Contact Information

DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC
4115 N. 91ST AVE.
PHOENIX, AZ85037
 Phone: 623-604-6723
 Fax: 480-741-8850
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC

NPI Number 1073204012
LBN Legal business name DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC
Authorized official GLENN ASHMORE - (OWNER / CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/19/2023
Last updated 05/30/2025 - More than a year ago
Identifiers n/a
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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