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MY PEDIATRIC DENTIST PLLC
NPI 1063374593
Dentist - Pediatric Dentistry in Mesa, AZ

Active since December 02, 2025
5215 E SOUTHERN AVE, MESA, AZ 85206(480) 833-2232 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About My Pediatric Dentist Pllc NPPES

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

MY PEDIATRIC DENTIST PLLC (NPI 1063374593) is a healthcare organization registered as a pediatric dentistry in Mesa, Arizona and active in the NPI registry since December 2025. The organization lists Austin Mchenry, Partner, as its authorized official.

NPPES Registry Identity

NPI1063374593
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameMY PEDIATRIC DENTIST PLLC
Location Address5215 E SOUTHERN AVEMesa, AZ 85206-2777
Mailing Address2045 S Vineyard Ste 153Mesa, AZ 85210-6892
Phone(480) 833-2232
Organization SubpartNo
Authorized OfficialAustin MchenryPartner · (602) 384-7506
Enumeration DateDecember 2, 2025
NPPES CertifiedDecember 2, 2025
✔ NPI 1063374593 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
5215 E SOUTHERN AVE, Mesa, AZ 85206
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PEPSQUAD PLLC
Dentist
5215 E SOUTHERN AVE
MESA, AZ 85206
Maricopa County (509) 823-4480

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is My Pediatric Dentist PLLC's NPI number?

The NPI number for My Pediatric Dentist PLLC is 1063374593. It was assigned to this organization in the NPPES registry on December 2, 2025.

Where is My Pediatric Dentist PLLC located?

My Pediatric Dentist PLLC is located at 5215 E Southern Ave, Mesa, AZ 85206. The listed phone number is (480) 833-2232.

What is My Pediatric Dentist PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for My Pediatric Dentist PLLC was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.