| Wellness Dental Tatum/shea | |
|
10214 N Tatum Blvd B600 Phoenix AZ 85028-4231 | |
| (602) 899-0488 | |
| Not Available |
| Full Name | Wellness Dental Tatum/shea |
|---|---|
| Speciality | Dentist |
| Location | 10214 N Tatum Blvd, Phoenix, Arizona |
| Authorized Official Name and Position | Dongsuk Kwak (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6028990488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellness Dental Tatum/shea 10214 N Tatum Blvd B600 Phoenix AZ 85028-4231 Ph: (602) 899-0488 | Wellness Dental Tatum/shea 10214 N Tatum Blvd B600 Phoenix AZ 85028-4231 Ph: (602) 899-0488 |
| NPI Number | 1194116475 |
|---|---|
| Provider Enumeration Date | 02/09/2015 |
| Last Update Date | 11/14/2022 |
| Medicare PECOS PAC ID | 9234508714 |
|---|---|
| Medicare Enrollment ID | O20221205001710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194116475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | F000542 (Arizona) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| Provider Name | Han Choi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891040028 PECOS PAC ID: 6103186390 Enrollment ID: I20211006001929 |
| Provider Name | Matthew Jensen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831438787 PECOS PAC ID: 4183055767 Enrollment ID: I20231229002941 |
Orthodontic Centers Of Az Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2330 N 75th Ave, #111, Phoenix, AZ 85035 Phone: 623-849-0880 Fax: 623-849-0329 | |
Prime Dental Care, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5030 West Baseline Road, Phoenix, AZ 85339 Phone: 602-237-8880 | |
Sonrisas Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6524 W Indian School Rd, Phoenix, AZ 85033 Phone: 623-247-7409 | |
Solterra Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15255 N 40th St Ste 111, Phoenix, AZ 85032 Phone: 602-788-0730 | |
Uptown Pediatric Dental Group, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1515 E Missouri Ave Ste 103, Phoenix, AZ 85014 Phone: 602-279-2981 | |
Purely Dental Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12320 N 32nd St Ste 2, Phoenix, AZ 85032 Phone: 602-354-5356 | |
Herring Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4203 E Indian School Rd Ste 220, Phoenix, AZ 85018 Phone: 870-267-2294 |