Provider Demographics
NPI:1639064942
Name:TARR, EMILY A
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:TARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19519 N 66TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7052
Mailing Address - Country:US
Mailing Address - Phone:802-922-4499
Mailing Address - Fax:
Practice Address - Street 1:20800 W MARKET ST STE 107
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85396-8040
Practice Address - Country:US
Practice Address - Phone:480-400-4932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD012547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist