Provider Demographics
NPI:1124232392
Name:ARIZONA SUNSET DENTAL
Entity Type:Organization
Organization Name:ARIZONA SUNSET DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:OSETE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-797-4551
Mailing Address - Street 1:2205 W MAGEE RD STE 124
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-4312
Mailing Address - Country:US
Mailing Address - Phone:520-797-4551
Mailing Address - Fax:520-797-8005
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:SUITE 206
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-797-4551
Practice Address - Fax:520-797-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
AZ4364261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty