COTTONWOOD KIDS DENTAL LLC – NPI #1073403911
Clinic/Center

COTTONWOOD KIDS DENTAL LLC is an AHC clinic located in COTTONWOOD, AZ. NPPES has assigned the NPI number 1073403911 to COTTONWOOD KIDS DENTAL LLC on July 03, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

The NPI profile was last updated on Oct 03, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for COTTONWOOD KIDS DENTAL LLC below.

NPI Profile for
COTTONWOOD KIDS DENTAL LLC

NPI Number
1073403911
Enumeration Date

(about a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COTTONWOOD KIDS DENTAL LLC
Primary location
2180 AZ 89A
COTTONWOOD, AZ 86326
Phone: (954) 557-7399 Fax:
Mailing address
4208 E ROMA AVE
PHOENIX, AZ 85018-4251
Phone: Fax:
Organization Subpart
No
Authorized Official
JORDAN JANIS
OWNER/DENTIST
Phone: (954) 557-7399
Updated
Certification Date
Oct 03, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QD0000X
- Clinic/Center / Dental (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.