DENTAL DEPOT OF SURPRISE, PLLC – NPI #1912538497
Clinic/Center

DENTAL DEPOT OF SURPRISE, PLLC is an AHC clinic located in SURPRISE, AZ. NPPES has assigned the NPI number 1912538497 to DENTAL DEPOT OF SURPRISE, PLLC on February 03, 2020. 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 Jun 13, 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 DENTAL DEPOT OF SURPRISE, PLLC below.

NPI Profile for
DENTAL DEPOT OF SURPRISE, PLLC

NPI Number
1912538497
Enumeration Date

(more than 6 years 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
DENTAL DEPOT OF SURPRISE, PLLC
Primary location
13828 W. GREENWAY RD.
SURPRISE, AZ 85374
Phone: (623) 562-9123 Fax: (623) 259-0153
Mailing address
2828 NW 30TH ST
OKLAHOMA CITY, OK 73112-7404
Phone: (623) 562-9123 Fax: (623) 259-0153
Organization Subpart
No
Authorized Official
GLENN ASHMORE
OWNER / CEO
Phone: (405) 945-8941
Updated
Certification Date
Jun 13, 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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
13828 W. GREENWAY RD.,
SURPRISE, AZ 77025-1669
Endpoint
dentaldepot.net
Endpoint type
Other URL
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
13828 W GREENWAY RD,
SURPRISE, AZ 77025-1669