Provider Demographics
NPI:1235006875
Name:ANTHEM ENDO PLLC
Entity type:Organization
Organization Name:ANTHEM ENDO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FOISY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-622-5123
Mailing Address - Street 1:42104 N VENTURE DR STE B134
Mailing Address - Street 2:
Mailing Address - City:ANTHEM
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3830
Mailing Address - Country:US
Mailing Address - Phone:623-250-0184
Mailing Address - Fax:
Practice Address - Street 1:42104 N VENTURE DR STE B134
Practice Address - Street 2:
Practice Address - City:ANTHEM
Practice Address - State:AZ
Practice Address - Zip Code:85086-3830
Practice Address - Country:US
Practice Address - Phone:623-250-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty