Provider Demographics
NPI:1023295318
Name:GREENWAY AIRPARK FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:GREENWAY AIRPARK FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CHEN
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-867-4000
Mailing Address - Street 1:8300 E DIXILETA DR
Mailing Address - Street 2:SUITE 229
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-2273
Mailing Address - Country:US
Mailing Address - Phone:602-867-4000
Mailing Address - Fax:602-867-3996
Practice Address - Street 1:4910 E GREENWAY RD
Practice Address - Street 2:SUITE 5
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1653
Practice Address - Country:US
Practice Address - Phone:602-867-4000
Practice Address - Fax:602-867-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4828261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental