Provider Demographics
NPI:1699220863
Name:ACHATZ, CHAD WILLIAM (DMD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:WILLIAM
Last Name:ACHATZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8878 E SHEENA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7058
Mailing Address - Country:US
Mailing Address - Phone:971-235-3570
Mailing Address - Fax:
Practice Address - Street 1:7342 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7219
Practice Address - Country:US
Practice Address - Phone:480-935-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60682826122300000X
AZD009991122300000X, 1223G0001X
ORD10533122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist