Provider Demographics
NPI:1275391872
Name:STELLAR ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:STELLAR ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NUO
Authorized Official - Middle Name:
Authorized Official - Last Name:DONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:626-684-2960
Mailing Address - Street 1:3875 E WILLIAMS FIELD RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295
Mailing Address - Country:US
Mailing Address - Phone:480-389-2020
Mailing Address - Fax:480-389-2220
Practice Address - Street 1:3875 E WILLIAMS FIELD RD
Practice Address - Street 2:SUITE 302
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:480-389-2020
Practice Address - Fax:480-389-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty