Canyonlands Health Care - Beaver Dam is a medicare enrolled dental clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Littlefield, Arizona. The current practice location for Canyonlands Health Care - Beaver Dam is 3272 E Rio Virgin Road, Littlefield, Arizona. For appointments, you can reach them via phone at
(928) 347-5971. The mailing address for Canyonlands Health Care - Beaver Dam is P O Box 1625, 827 Vista Avenue, Page, Arizona and phone number is (928) 645-9675.
Canyonlands Health Care - Beaver Dam is licensed to practice in Arizona (license number ). The clinic also participates in the medicare program and its
NPI number is 1780653741. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(928) 347-5971.
Dental Care Clinic Profile
| Full Name | Canyonlands Health Care - Beaver Dam |
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| Speciality | Clinic/Center |
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| Location | 3272 E Rio Virgin Road, Littlefield, Arizona |
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| Authorized Official Name and Position | Christopher J Hansen (CEO) |
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| Authorized Official Contact | 9286459675 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Canyonlands Health Care - Beaver Dam
P O Box 1625
827 Vista Avenue
Page
AZ 86040-1625
Ph: (928) 645-9675 | Canyonlands Health Care - Beaver Dam
3272 E Rio Virgin Road
Littlefield
AZ 86432-3200
Ph: (928) 347-5971 |
NPI Details:
| NPI Number | 1780653741 |
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| Provider Enumeration Date | 03/14/2006 |
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| Last Update Date | 09/23/2021 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 4082509591 |
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| Medicare Enrollment ID | O20090226000140 |
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Medical Identifiers
Medical identifiers for Canyonlands Health Care - Beaver Dam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780653741 | NPI | - | NPPES |
| 100509882 | Medicaid | NV | |
| 594011 | Medicaid | AZ | |
| 432857 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (Arizona) | Secondary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 261QC1500X | Clinic/center - Community Health | (Arizona) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Arizona) | Primary |
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