Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EAST VALLEY IMPLANT AND PERIODONTAL PLLC
NPI 1457900656
Dentist - Periodontics in Mesa, AZ

Q: What is East Valley Implant And Periodontal PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Active since September 10, 2019

3048 E BASELINE RD STE 112, MESA, AZ 85204(480) 376-2848 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2026, Sep 10, 2019 (2 updates tracked since 2019).

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About East Valley Implant And Periodontal Pllc NPPES

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

EAST VALLEY IMPLANT AND PERIODONTAL PLLC (NPI 1457900656) is a healthcare organization registered as a periodontics in Mesa, Arizona and active in the NPI registry since September 2019. The organization lists Victoria Johnson, Cro, as its authorized official.

NPPES Registry Identity

NPI1457900656

Entity TypeOrganization

Primary Taxonomy1223P0300X

Legal Business NameEAST VALLEY IMPLANT AND PERIODONTAL PLLC

Location Address3048 E BASELINE RD STE 112Mesa, AZ 85204-7287

Mailing Address8952 E Desert Cove Ave # D101Scottsdale, AZ 85260-6775 · (480) 376-2848

Phone(480) 376-2848

Organization SubpartNo

Authorized OfficialVictoria JohnsonCro · (941) 444-0558

Enumeration DateSeptember 10, 2019

Last NPPES UpdateJuly 21, 20262 updates tracked since enumeration

NPPES CertifiedJuly 21, 2026

✔ NPI 1457900656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers

Taxonomy Code1223P0300X

Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

3048 E BASELINE RD STE 112, Mesa, AZ 85204

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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

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

EAST VALLEY IMPLANT & PERIODONTAL CENTER

Dentist (Periodontics)

3048 E BASELINE RD STE 112
MESA, AZ 85204

Maricopa County (480) 558-4504

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 East Valley Implant And Periodontal PLLC's NPI number?

The NPI number for East Valley Implant And Periodontal PLLC is 1457900656. It was assigned to this organization in the NPPES registry on September 10, 2019.

Where is East Valley Implant And Periodontal PLLC located?

East Valley Implant And Periodontal PLLC is located at 3048 E Baseline Rd Ste 112, Mesa, AZ 85204. The listed phone number is (480) 376-2848.

What is East Valley Implant And Periodontal PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for East Valley Implant And Periodontal PLLC was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days 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.