Soh of Arizona Specialty LLC
NPI 1104554179ActiveOrganization· Dentist, Orthodontics and Dentofacial Orthopedics· Glendale, AZ
Dentist, Orthodontics and Dentofacial Orthopedics in Glendale, Arizona, registered in NPPES in August 2022, part of Soh of Arizona Specialty LLC. The authorized official on file is Ashly Kristine Sunshine, Credentialing Specialist.
Overview
| NPI | 1104554179 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Soh of Arizona Specialty LLC |
| NPI issued | Aug 9, 2022 |
| Last updated in NPPES | Sep 28, 2026 |
| Certified by provider | Sep 28, 2026 |
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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