Provider Demographics
NPI:1083767768
Name:WEST VALLEY PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:WEST VALLEY PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:BROWNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-935-9873
Mailing Address - Street 1:13575 W INDIAN SCHOOL RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD PARK
Mailing Address - State:AZ
Mailing Address - Zip Code:85340-4926
Mailing Address - Country:US
Mailing Address - Phone:623-935-9873
Mailing Address - Fax:623-935-3626
Practice Address - Street 1:13575 W INDIAN SCHOOL RD STE 1000
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4926
Practice Address - Country:US
Practice Address - Phone:623-935-9873
Practice Address - Fax:623-935-3626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD51641223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty