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GREENWAY DENTAL LAB INC.
NPI 1053960500
Dental Laboratory Technician in Phoenix, AZ

Active since September 07, 2019
1855 W GREENWAY RD STE 109, PHOENIX, AZ 85023(602) 242-2303 Get Directions Write a Review

NPPES record last updated: September 7, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Greenway Dental Lab Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREENWAY DENTAL LAB INC. (NPI 1053960500) is a healthcare organization registered as a dental laboratory technician in Phoenix, Arizona and active in the NPI registry since September 2019. The organization lists Matthew Frketich, Owner, as its authorized official.

NPPES Registry Identity

NPI1053960500
Entity TypeOrganization
Primary Taxonomy126900000X
Legal Business NameGREENWAY DENTAL LAB INC.
Location Address1855 W GREENWAY RD STE 109Phoenix, AZ 85023-3475
Mailing Address1855 W Greenway Rd Ste 109Phoenix, AZ 85023-3475 · (602) 242-2303
Phone(602) 242-2303
Organization SubpartNo
Authorized OfficialMatthew FrketichOwner · (602) 242-2303
Enumeration DateSeptember 7, 2019
✔ NPI 1053960500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDental Laboratory TechnicianDental Providers
Taxonomy Code126900000X
Definition

An individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laboratory work authorization. To avoid misleading the public, no occupational title other than dental laboratory technician or certified dental technician (when appropriate) should be used to describe this auxiliary.

1855 W GREENWAY RD STE 109, Phoenix, AZ 85023
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2274300

Greenway Surgery Centers · Phoenix, AZ
Active · expires Dec 29, 2026
CLIA Number03D2274300
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 30, 2024
Certificate Expiration DateDecember 29, 2026
Laboratory DirectorTodd Turley
Laboratory Phone(480) 573-0130
Laboratory LocationGreenway Surgery Centers2525 W Greenway Rd Ste 100, Phoenix, AZ 85023
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is GREENWAY DENTAL LAB INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1053960500, enumerated as an "organization" on September 07, 2019.

Where is the provider located?

The provider is located at 1855 W GREENWAY RD STE 109 PHOENIX, AZ 85023 and the phone number is (602) 242-2303.

What is the provider's specialty?

Dental Laboratory Technician with taxonomy code 126900000X.