Provider Demographics
NPI:1811251580
Name:ARMSTRONG, JOSHUA M (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:M
Last Name:ARMSTRONG
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 1:812 MEADE AVE
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-2463
Mailing Address - Country:US
Mailing Address - Phone:801-358-3655
Mailing Address - Fax:
Practice Address - Street 1:5215 E BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2499
Practice Address - Country:US
Practice Address - Phone:801-358-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029052122300000X
AZ93831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist