Provider Demographics
NPI:1558656223
Name:SAIZ, FATIMA PIMENTEL (DMD)
Entity Type:Individual
Prefix:MRS
First Name:FATIMA
Middle Name:PIMENTEL
Last Name:SAIZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:FATIMA
Other - Middle Name:PERALTA
Other - Last Name:PIMENTEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7505 W. DEER VALLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382
Mailing Address - Country:US
Mailing Address - Phone:623-572-5777
Mailing Address - Fax:623-572-7288
Practice Address - Street 1:7505 W. DEER VALLEY RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2107
Practice Address - Country:US
Practice Address - Phone:623-572-5777
Practice Address - Fax:623-572-7288
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZD0099821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ393817Medicaid