SUN LIFE PEDIATRIC DENTISTRY – NPI #1992166359
Clinic/Center

SUN LIFE PEDIATRIC DENTISTRY is an AHC clinic located in CASA GRANDE, AZ. NPPES has assigned the NPI number 1992166359 to SUN LIFE PEDIATRIC DENTISTRY on March 14, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SUN LIFE PEDIATRIC DENTISTRY” is a dba name, the actual legal business name for this organization is SUN LIFE FAMILY HEALTH CENTER, INC.. 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 previously updated about 9 years ago on Aug 03, 2017. 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 SUN LIFE PEDIATRIC DENTISTRY below.

NPI Profile for
SUN LIFE FAMILY HEALTH CENTER, INC.

NPI Number
1992166359
Enumeration Date

(more than 10 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
SUN LIFE FAMILY HEALTH CENTER, INC.
Doing Business As (dba): SUN LIFE PEDIATRIC DENTISTRY
Primary location
1864 E FLORENCE BLVD
SUITE1
CASA GRANDE, AZ 85122-5457
Phone: (520) 836-3446 Fax: (520) 836-8807
Mailing address
PO BOX 10097
CASA GRANDE, AZ 85130-0020
Phone: (520) 836-3446 Fax: (520) 836-8807
Organization Subpart
No
Authorized Official
TRAVIS ROBINETTE
CHIEF EXECUTIVE OFFICER
Phone: (520) 836-3446
Updated
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)
AZ BL-16-58324

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.