Provider Demographics
NPI:1861993040
Name:JOSEPH E. PIERSE, DMD, PLLC
Entity type:Organization
Organization Name:JOSEPH E. PIERSE, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-938-0665
Mailing Address - Street 1:2060 W WHISPERING WIND DR STE 167
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-2869
Mailing Address - Country:US
Mailing Address - Phone:623-518-2325
Mailing Address - Fax:623-547-6002
Practice Address - Street 1:2060 W WHISPERING WIND DR STE 167
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-2869
Practice Address - Country:US
Practice Address - Phone:623-518-2325
Practice Address - Fax:623-547-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0095621223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty