| NPI | 1063015576 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2020-11-17 |
| Last Updated | 2023-04-23 |
| Authorized Official | Albert Tae CEO Phone: 4243922715 |
| Mailing Address | 3440 W Cactus Rd Ste 1 Phoenix, AZ 85029-2238 United States Phone: (623) 688-3364 | Fax: (623) 244-0333 📍 View Map |
| Primary Practice Address | 3440 W Cactus Rd Ste 1 Phoenix, AZ 85029-2238 United States Phone: (623) 688-3364 | Fax: (623) 244-0333 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | AZ | 2020P06513 | Arizona Department of Public Safety |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 1223P0221X – Dentist, Pediatric Dentistry | — | — |
| No | 1223S0112X – Dentist, Oral and Maxillofacial Surgery | — | — |
| No | 1223X0400X – Dentist, Orthodontics and Dentofacial Orthopedics | — | — |
| No | 124Q00000X – Dental Hygienist | — | — |
| No | 126800000X – Dental Assistant | — | — |
| Yes | 1223G0001X – Dentist, General Practice | — | — |
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About NPI 1063015576
Starlight Dental Services Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1063015576. The primary specialty listed is Dentist, General Practice. The organization is located in Phoenix, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2020-11-17. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1063015576?
NPI 1063015576 belongs to Starlight Dental Services Inc, a Dentist, General Practice in Phoenix, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1063015576 active?
The current status of NPI 1063015576 in the NPPES registry is Active. The record was last updated on 2023-04-23.
What specialty is NPI 1063015576?
NPI 1063015576 is classified under the taxonomy Dentist, General Practice. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1063015576?
You can verify NPI 1063015576 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1063015576?
The primary practice address on file for NPI 1063015576 is 3440 W Cactus Rd Ste 1, Phoenix, AZ 85029-2238. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1063015576 issued?
NPI 1063015576 was first issued (enumerated) on 2020-11-17. The NPPES record was last updated on 2023-04-23.
Practice Location Map
Starlight Dental Services Inc is located at 3440 W Cactus Rd Ste 1, Phoenix, AZ. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Starlight Dental Services Inc. All records sourced from the CMS NPPES registry.