Provider Demographics
NPI:1568650877
Name:BRIGGS, ROGER A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:A
Last Name:BRIGGS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6920 E SHEA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-7100
Mailing Address - Country:US
Mailing Address - Phone:480-699-1017
Mailing Address - Fax:480-991-7168
Practice Address - Street 1:6920 E SHEA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6180
Practice Address - Country:US
Practice Address - Phone:480-948-7670
Practice Address - Fax:480-991-7168
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD18721223G0001X
AZD018721223X2210X, 332B00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
No1223X2210XDental ProvidersDentistOrofacial Pain
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies