Provider Demographics
NPI:1003353822
Name:LENNY W ARIAS DDS PLLC
Entity Type:Organization
Organization Name:LENNY W ARIAS DDS PLLC
Other - Org Name:SABINO DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LENNY
Authorized Official - Middle Name:WILNELIA
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-299-5122
Mailing Address - Street 1:4955 N SABINO CANYON RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-6491
Mailing Address - Country:US
Mailing Address - Phone:520-299-5122
Mailing Address - Fax:520-232-9015
Practice Address - Street 1:4955 N SABINO CANYON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-6491
Practice Address - Country:US
Practice Address - Phone:520-299-5122
Practice Address - Fax:520-232-9015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD068621223G0001X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty