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CANYON TRAILS FAMILY DENTAL, LLC
NPI 1104282425
Dentist - General Practice in Goodyear, AZ

Active since January 04, 2016
500 N ESTRELLA PKWY, SUITE B-1, GOODYEAR, AZ 85338(623) 882-0782(623) 882-0878 Get Directions Write a Review

NPPES record last updated: January 4, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Canyon Trails Family Dental, Llc NPPES

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

CANYON TRAILS FAMILY DENTAL, LLC (NPI 1104282425) is a healthcare organization registered as a general practice in Goodyear, Arizona and active in the NPI registry since January 2016. The organization lists John E Ballard, Cfo, Cio, as its authorized official.

NPPES Registry Identity

NPI1104282425
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCANYON TRAILS FAMILY DENTAL, LLC
Location Address500 N ESTRELLA PKWY, SUITE B-1Goodyear, AZ 85338-4135
Mailing Address4435 E Holmes Ave, Suite #200Mesa, AZ 85206-3372 · (480) 889-9457 · Fax (480) 696-5505
Phone(623) 882-0782
Fax(623) 882-0878
Organization SubpartNo
Authorized OfficialJohn E BallardCfo, Cio · (480) 889-9457
Enumeration DateJanuary 4, 2016
✔ NPI 1104282425 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.
500 N ESTRELLA PKWY, Goodyear, AZ 85338
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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

Other Providers at the Same Location NPPES 9

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

CANYON TRAILS DENTAL CARE, PC
Dentist
500 N ESTRELLA PKWY, SUITE B1
GOODYEAR, AZ 85338
Maricopa County (623) 882-0782
DR. ASHLEY ANN HEID D.M.D
Dentist (General Practice)
500 N ESTRELLA PKWY, SUITE B-1
GOODYEAR, AZ 85338
Maricopa County (623) 882-0878
EBCON OPTICS LLC
Optometrist
500 N ESTRELLA PKWY
GOODYEAR, AZ 85338
Maricopa County (623) 980-5496
BRENT RICHARD STANLEY D.D.S
Dentist
500 N ESTRELLA PKWY, SUITE B-1
GOODYEAR, AZ 85338
Maricopa County (623) 882-0782
MARK DELWYN WHEELER D.M.D
Dentist
500 N ESTRELLA PKWY, SUITE B-1
GOODYEAR, AZ 85338
Maricopa County (623) 882-0782
MRS. HANNAH GOLONKA MSCN
Nutritionist
500 N ESTRELLA PKWY
GOODYEAR, AZ 85338
Maricopa County (480) 788-3794
DR. CLAUDIO COSIO DMD
Dentist
500 N ESTRELLA PKWY
GOODYEAR, AZ 85338
Maricopa County (623) 688-5408
DR. FREDERICK CHARLES BUENSUCESO O.D.
Optometrist
500 N ESTRELLA PKWY
GOODYEAR, AZ 85338
Maricopa County (623) 980-5496

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 Canyon Trails Family Dental, LLC's NPI number?

The NPI number for Canyon Trails Family Dental, LLC is 1104282425. It was assigned to this organization in the NPPES registry on January 4, 2016.

Where is Canyon Trails Family Dental, LLC located?

Canyon Trails Family Dental, LLC is located at 500 N Estrella Pkwy Suite B-1, Goodyear, AZ 85338. The listed phone number is (623) 882-0782.

What is Canyon Trails Family Dental, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Canyon Trails Family Dental, LLC was last updated on January 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.