Provider Demographics
NPI:1962818633
Name:HESLINGTON, CODY (DMD)
Entity Type:Individual
Prefix:DR
First Name:CODY
Middle Name:
Last Name:HESLINGTON
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 1:21755 N 77TH AVE STE 1210
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-2112
Mailing Address - Country:US
Mailing Address - Phone:623-248-0899
Mailing Address - Fax:623-248-9951
Practice Address - Street 1:21755 N 77TH AVE STE 1210
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2112
Practice Address - Country:US
Practice Address - Phone:623-248-0899
Practice Address - Fax:623-248-9951
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ96081223E0200X
IA30407390200000X
AZD0096081223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program