COUNTRY CLUB DENTAL INC.
NPI 1417121880
Dentist - General Practice in Mesa, AZ

Q: What is Country Club Dental Inc.'s NPI number?

The NPI number for Country Club Dental Inc. is 1417121880. It was assigned to this organization in the NPPES registry on April 16, 2008.

Q: What is Country Club Dental Inc.'s specialty?

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

Active since April 16, 2008

3050 S COUNTRY CLUB DR STE 18, MESA, AZ 85210(480) 892-8185 Get Directions Write a Review

NPPES record last updated: April 16, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Country Club Dental Inc. NPPES

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

COUNTRY CLUB DENTAL INC. (NPI 1417121880) is a healthcare organization registered as a general practice in Mesa, Arizona and active in the NPI registry since April 2008. The organization lists Frances Joann Fattohi, Owner, as its authorized official.

NPPES Registry Identity

NPI1417121880

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameCOUNTRY CLUB DENTAL INC.

Location Address3050 S COUNTRY CLUB DR STE 18Mesa, AZ 85210-8365

Mailing Address3050 S Country Club Dr Ste 18Mesa, AZ 85210-8365 · (480) 892-8185

Phone(480) 892-8185

Organization SubpartNo

Authorized OfficialFrances Joann FattohiOwner · (480) 892-8185

Enumeration DateApril 16, 2008

✔ NPI 1417121880 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.

3050 S COUNTRY CLUB DR STE 18, Mesa, AZ 85210

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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

Accepted Insurance

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

Other Providers at the Same Location NPPES

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

NEIL S. REISER DDS

Dentist (General Practice)

3050 S COUNTRY CLUB DR STE 18
MESA, AZ 85210

Maricopa County (480) 892-8185

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 Country Club Dental Inc.'s NPI number?

The NPI number for Country Club Dental Inc. is 1417121880. It was assigned to this organization in the NPPES registry on April 16, 2008.

Where is Country Club Dental Inc. located?

Country Club Dental Inc. is located at 3050 S Country Club Dr Ste 18, Mesa, AZ 85210. The listed phone number is (480) 892-8185.

What is Country Club Dental Inc.'s specialty?

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

What insurance does Country Club Dental Inc. accept?

Health plans from Ambetter from Arizona Complete Health list Country Club Dental Inc. 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 Country Club Dental Inc. was last updated on April 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.