Provider Demographics
NPI:1548081037
Name:DMD DENTAL
Entity type:Organization
Organization Name:DMD DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DU MOND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:504-400-4454
Mailing Address - Street 1:9082 E CASITAS DEL RIO DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-8344
Mailing Address - Country:US
Mailing Address - Phone:504-400-4454
Mailing Address - Fax:
Practice Address - Street 1:7312 E DEER VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7452
Practice Address - Country:US
Practice Address - Phone:480-573-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty