1043294424 NPI number — DR. BRIAN WILLIAM ALLMENDINGER DDS

Table of content: (NPI 1013752963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043294424 NPI number — DR. BRIAN WILLIAM ALLMENDINGER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLMENDINGER
Provider First Name:
BRIAN
Provider Middle Name:
WILLIAM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043294424
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5551 E ORCHID LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARADISE VALLEY
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-782-8532
Provider Business Mailing Address Fax Number:
480-855-8316

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
655 S DOBSON RD
Provider Second Line Business Practice Location Address:
BUILDING B SUITE 214
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85224-5667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-855-8315
Provider Business Practice Location Address Fax Number:
480-855-8316
Provider Enumeration Date:
11/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  D5353 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 570475 . This is a "A.H.C.C.C.S." identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".