Provider Demographics
NPI:1609022805
Name:ARCADIA DENTAL GROUP
Entity Type:Organization
Organization Name:ARCADIA DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-954-2177
Mailing Address - Street 1:4840 E INDIAN SCHOOL RD STE 107
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5500
Mailing Address - Country:US
Mailing Address - Phone:602-954-2177
Mailing Address - Fax:602-954-2411
Practice Address - Street 1:4840 E INDIAN SCHOOL RD STE 107
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5500
Practice Address - Country:US
Practice Address - Phone:602-954-2177
Practice Address - Fax:602-954-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7425122300000X
AZD6702122300000X
AZD70481223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty