Az Specialty Dental Services, LLC
NPI 1053136663ActiveOrganization· Dentist, Orthodontics and Dentofacial Orthopedics· Peoria, AZ
Dentist, Orthodontics and Dentofacial Orthopedics in Peoria, Arizona, registered in NPPES in November 2024, part of Az Specialty Dental Services, LLC. The authorized official on file is Charlotte V. Dasch, Director Of Cred And Prov Rel.
Overview
| NPI | 1053136663 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Az Specialty Dental Services, LLC |
| NPI issued | Nov 19, 2024 |
| Last updated in NPPES | Nov 19, 2024 |
| Certified by provider | Nov 19, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics Primary | 1223X0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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