Pacific Dental Services Foundation
NPI 1659848208ActiveOrganization· Physician Assistant, Medical· Phoenix, AZ
Physician Assistant, Medical in Phoenix, Arizona, registered in NPPES in October 2018. The authorized official on file is Jack Dillenberg, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1659848208 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 31, 2018 |
| Last updated in NPPES | Mar 28, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
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) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
Other Physician Assistant, Medical providers in Phoenix
- 1164851788
- 1124440979
- 1619407269
- 1720107659
- 1558927921
- 1548651599
- 1104583582
- 1982603601
- 1316064363
- 1962802736
- 1912158551
- 1588635643