Provider Demographics
NPI:1013182567
Name:PINNACLE PEAK DENTALCARE
Entity Type:Organization
Organization Name:PINNACLE PEAK DENTALCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-659-9499
Mailing Address - Street 1:8900 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3644
Mailing Address - Country:US
Mailing Address - Phone:480-659-9499
Mailing Address - Fax:480-659-3609
Practice Address - Street 1:8900 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3644
Practice Address - Country:US
Practice Address - Phone:480-659-9499
Practice Address - Fax:480-659-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7275261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental