CANYON MODERN DENTISTRY & ORTHODONTICS
NPI 1366848897
Clinic/Center - Dental in Surprise, AZ
NPI Status: Active since November 11, 2014
Contact Information
17081 W GREENWAY RD
SUITE 120
SURPRISE, AZ
ZIP 85388
Phone: (623) 546-8400
Fax: (623) 214-5830
- Organization
- Clinic/Center
- Dental
- CLIA Number: 03D2256776
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 03-27-2026
About CANYON MODERN DENTISTRY & ORTHODONTICS
This page provides the complete NPI Profile along with additional information for Canyon Modern Dentistry & Orthodontics, a provider established in Surprise, Arizona operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1366848897 assigned on November 2014. The practitioner's primary taxonomy code is 261QD0000X with license number D009075 (AZ). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Dr. Mohammed Reza Khakwani Dmd (General Dentist)
- NPI
- 1366848897
- Provider Name
- CANYON MODERN DENTISTRY & ORTHODONTICS
- Entity Type
- Organization
- Location Address
- 17081 W GREENWAY RD SUITE 120 SURPRISE, AZ 85388
- Location Phone
- (623) 546-8400
- Location Fax
- (623) 214-5830
- Mailing Address
- 17081 W GREENWAY RD SUITE 120 SURPRISE, AZ 85388
- Mailing Phone
- (623) 546-8400
- Mailing Fax
- (623) 214-5830
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-11-2014
- Last Update Date
- 11-11-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Dental
- Taxonomy Code
- 261QD0000X
- Type
- Ambulatory Health Care Facilities
- License No.
- D009075
- License State
- AZ
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D2256776
- Facility Type
- Practitioner Other
- Certificate Effective Date
- March 28, 2024
- Certificate Expiration Date
- March 27, 2026
- Laboratory Director
- MOHAMMED KHAKWANI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Canyon Modern Dentistry & Orthodontics to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366848897, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366848897, enumerated as an "organization" on November 11, 2014.
The provider is located at 17081 W GREENWAY RD SUITE 120 SURPRISE, AZ 85388 and the phone number is (623) 546-8400.
Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.
