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FIESTA KIDTASTICS
NPI 1215281688
Dentist - Pediatric Dentistry in Mesa, AZ

Active since November 06, 2012
1303 S LONGMORE STE 1, MESA, AZ 85202(480) 648-4037(480) 696-5505 Get Directions Write a Review

NPPES record last updated: December 6, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Fiesta Kidtastics NPPES

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

FIESTA KIDTASTICS (NPI 1215281688) is a healthcare organization registered as a pediatric dentistry in Mesa, Arizona and active in the NPI registry since November 2012. The organization lists Jaime Johnson, Controller, as its authorized official.

NPPES Registry Identity

NPI1215281688
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NameFIESTA KIDTASTIC, LLC
Location Address1303 S LONGMORE STE 1Mesa, AZ 85202-9607
Mailing Address4704 E Southern AveMesa, AZ 85206-2737 · (480) 648-4037 · Fax (480) 696-5505
Phone(480) 648-4037
Fax(480) 696-5505
Organization SubpartNo
Authorized OfficialJaime JohnsonController · (480) 648-4037
Enumeration DateNovember 6, 2012
Last NPPES UpdateDecember 6, 2013
✔ NPI 1215281688 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.
1303 S LONGMORE STE 1, Mesa, AZ 85202
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Other Names 1

Doing Business AsFiesta Kidtastics

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 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 Fiesta Kidtastic, LLC's NPI number?

The NPI number for Fiesta Kidtastic, LLC is 1215281688. It was assigned to this organization in the NPPES registry on November 6, 2012. The provider is doing business as Fiesta Kidtastics.

Where is Fiesta Kidtastic, LLC located?

Fiesta Kidtastic, LLC is located at 1303 S Longmore Ste 1, Mesa, AZ 85202. The listed phone number is (480) 648-4037.

What is Fiesta Kidtastic, LLC's specialty?

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

What insurance does Fiesta Kidtastic, LLC accept?

Health plans from UnitedHealthcare list Fiesta Kidtastic, LLC 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 Fiesta Kidtastic, LLC was last updated on December 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.