Jc Dental Dream Consulting LLC
Clinic/Center, Dental in Peoria, AZ. Organization (NPI-2).
NPI number1003564071
StatusActive
Last updated in NPPESMar 17, 2022
Details
- NPI
- 1003564071
- Entity type
- Organization (NPI-2)
- Legal business name
- Jc Dental Dream Consulting LLC
- Organization subpart
- No
- Enumeration date
- Mar 17, 2022
- Certification date
- Mar 15, 2022
- Last updated
- Mar 17, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
13660 N 94th DrPeoria, AZ 85381-4836
Phone 623-974-4799 · Fax 623-974-0132
Mailing address
13660 N 94th DrPeoria, AZ 85381-4836
Phone 623-974-4799 · Fax 623-974-0132
Authorized official
Juana Marie Castillo
Owner
6027187056
Is something wrong?
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