Canyon Vista Dental
NPI 1518515212ActiveOrganization· Dentist, General Practice· Sierra Vista, AZ
Dentist, General Practice in Sierra Vista, Arizona, registered in NPPES in August 2019. The authorized official on file is Marvin Blane Jackson, Dds/Owner.
Overview
| NPI | 1518515212 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 27, 2019 |
| Last updated in NPPES | Aug 27, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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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