Chandler Implants & Periodontics, LLC
Clinic/Center, Dental in Chandler, AZ. Organization (NPI-2).
NPI number1699013201
StatusActive
Last updated in NPPESJan 17, 2013
Details
- NPI
- 1699013201
- Entity type
- Organization (NPI-2)
- Legal business name
- Chandler Implants & Periodontics, LLC
- Organization subpart
- No
- Enumeration date
- Jan 17, 2013
- Last updated
- Jan 17, 2013
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 | D7899 | AZ | Yes |
Practice location
800 W Chandler Blvd Ste 1Chandler, AZ 85225-2508
Phone 480-899-6407 · Fax 480-899-2644
Mailing address
800 W Chandler Blvd Ste 1Chandler, AZ 85225-2508
Phone 480-899-6407 · Fax 480-899-2644
Authorized official
Jonathan Ryan Peterson
Owner
4808996407
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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