Provider Demographics
NPI:1639381197
Name:ANN HAMMI BLUE, D.D.S., M.S., P.C.
Entity Type:Organization
Organization Name:ANN HAMMI BLUE, D.D.S., M.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:HAMMI
Authorized Official - Last Name:BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, PC
Authorized Official - Phone:602-441-4464
Mailing Address - Street 1:4921 E BELL RD
Mailing Address - Street 2:SUITE #206
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6002
Mailing Address - Country:US
Mailing Address - Phone:602-441-4464
Mailing Address - Fax:602-441-0203
Practice Address - Street 1:4921 E BELL RD
Practice Address - Street 2:SUITE #206
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6002
Practice Address - Country:US
Practice Address - Phone:602-441-4464
Practice Address - Fax:602-441-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD5379261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental