DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC
NPI 1073204012
Dentist - General Practice in Phoenix, AZ

Q: What is Dental Depot 91st & Indian School, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since May 19, 2023

4115 N. 91ST AVE., PHOENIX, AZ 85037(623) 604-6723(480) 741-8850 Get Directions Write a Review

NPPES record last updated: May 30, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 30, 2025, May 19, 2023 (2 updates tracked since 2023).

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About Dental Depot 91st & Indian School, Pllc NPPES

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

DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC (NPI 1073204012) is a healthcare organization registered as a general practice in Phoenix, Arizona and active in the NPI registry since May 2023. The organization lists Glenn A Ashmore, Owner / Ceo, as its authorized official.

NPPES Registry Identity

NPI1073204012

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameDENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC

Location Address4115 N. 91ST AVE.Phoenix, AZ 85037

Mailing Address2828 Nw 30th StOklahoma City, OK 73112-7404 · (405) 945-8941 · Fax (405) 945-8959

Phone(623) 604-6723

Fax(480) 741-8850

Organization SubpartNo

Authorized OfficialGlenn A AshmoreOwner / Ceo · (405) 945-8941

Enumeration DateMay 19, 2023

Last NPPES UpdateMay 30, 20252 updates tracked since enumeration

NPPES CertifiedMay 30, 2025

✔ NPI 1073204012 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4115 N. 91ST AVE., Phoenix, AZ 85037

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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Solstice Healthplans of Arizona, Inc., UnitedHealthcare.Insurance ›

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 Dental Depot 91st & Indian School, PLLC's NPI number?

The NPI number for Dental Depot 91st & Indian School, PLLC is 1073204012. It was assigned to this organization in the NPPES registry on May 19, 2023.

Where is Dental Depot 91st & Indian School, PLLC located?

Dental Depot 91st & Indian School, PLLC is located at 4115 N. 91st Ave., Phoenix, AZ 85037. The listed phone number is (623) 604-6723.

What is Dental Depot 91st & Indian School, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Dental Depot 91st & Indian School, PLLC accept?

Health plans from Ambetter from Arizona Complete Health, Solstice Healthplans of Arizona, Inc. and UnitedHealthcare list Dental Depot 91st & Indian School, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dental Depot 91st & Indian School, PLLC was last updated on May 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.