Provider Demographics
NPI:1851438501
Name:TV ORTHODONTICS, P.C.
Entity Type:Organization
Organization Name:TV ORTHODONTICS, P.C.
Other - Org Name:AVALON ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VANLANDSCHOOT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:480-650-9927
Mailing Address - Street 1:4639 E RED RANGE WAY
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-5040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11144 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-2646
Practice Address - Country:US
Practice Address - Phone:480-451-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty