Vistancia Orthodontics | |
9772 W Yearling Rd Ste A1600 Peoria AZ 85383-1380 | |
(623) 566-0800 | |
(833) 330-2854 |
Full Name | Vistancia Orthodontics |
---|---|
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 9772 W Yearling Rd, Peoria, Arizona |
Authorized Official Name and Position | Devin Lee Croft (PRESIDENT) |
Authorized Official Contact | 6235660800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Vistancia Orthodontics 9772 W Yearling Rd Ste A1600 Peoria AZ 85383-1380 Ph: (623) 566-0800 | Vistancia Orthodontics 9772 W Yearling Rd Ste A1600 Peoria AZ 85383-1380 Ph: (623) 566-0800 |
NPI Number | 1225352289 |
---|---|
Provider Enumeration Date | 03/19/2010 |
Last Update Date | 10/13/2023 |
Medicare PECOS PAC ID | 7113054792 |
---|---|
Medicare Enrollment ID | O20100430000265 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225352289 | NPI | - | NPPES |
162964 | Medicaid | AZ | |
518939 | Medicaid | AZ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 7616 (Arizona) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Provider Name | Devin L Croft |
---|---|
Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1659520617 PECOS PAC ID: 9638206410 Enrollment ID: I20100525000434 |
Jeffrey C Kleiman Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13660 N 94th Dr, E-3, Peoria, AZ 85381 Phone: 623-974-4799 | |
Jc Dental Dream Consulting Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13660 N 94th Dr, Peoria, AZ 85381 Phone: 623-974-4799 Fax: 623-974-0132 | |
Stenopuntia Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7425 W Peoria Ave Ste 101, Peoria, AZ 85345 Phone: 623-848-1201 Fax: 623-848-1236 | |
Core Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13460 N 94th Dr Ste K4, Peoria, AZ 85381 Phone: 623-223-1036 | |
Tj Dental Corp Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 20542 N Lake Pleasant Rd, Ste #113, Peoria, AZ 85382 Phone: 602-884-8238 Fax: 602-884-8240 | |
Sitton, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9059 W Lake Pleasant Pkwy Ste 400, Peoria, AZ 85382 Phone: 208-591-0091 | |
Posh Dental Peoria Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21681 N 77th Ave Ste 1420, Peoria, AZ 85382 Phone: 623-376-7233 |