PACIFIC DENTAL SERVICES FOUNDATION
NPI 1659848208
Physician Assistant - Medical in Phoenix, AZ
About Pacific Dental Services Foundation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PACIFIC DENTAL SERVICES FOUNDATION (NPI 1659848208) is a healthcare organization registered as a medical in Phoenix, Arizona and active in the NPI registry since October 2018. The organization lists Jack Dillenberg, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pacific Dental Services Foundation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Pacific Dental Services Foundation, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Pacific Dental Services Foundation's NPI number?
The NPI number for Pacific Dental Services Foundation is 1659848208. It was assigned to this organization in the NPPES registry on October 31, 2018.
Where is Pacific Dental Services Foundation located?
Pacific Dental Services Foundation is located at 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032. The listed phone number is (714) 845-8500.
What is Pacific Dental Services Foundation's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Pacific Dental Services Foundation enrolled in Medicare?
Yes. Pacific Dental Services Foundation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Pacific Dental Services Foundation?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Oral Surgery) reassigns their Medicare billing to Pacific Dental Services Foundation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Pacific Dental Services Foundation accept?
Health plans from Ambetter Health, Ambetter from Arizona Complete Health and DentaQuest Insurance Company, Inc. list Pacific Dental Services Foundation 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 Pacific Dental Services Foundation was last updated on March 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Pacific Dental Services Foundation · NPI 1659848208
Medical organization in Phoenix, Arizona. Organization record, active in the CMS NPPES registry since October 31, 2018.
## Identity
- **NPI:** 1659848208 (Entity type: Organization)
- **Enumerated:** October 31, 2018
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **Organization subpart:** No
- **Authorized official:** Jack Dillenberg, OWNER
## Practice location
- **Address:** 4559 E. BELL ROAD, STE 106, Phoenix, AZ 85032
- **Phone:** (714) 845-8500 · **Fax:** (303) 952-0892
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Oral Surgery) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 28, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1659848208) · Data from the CMS NPPES public registry.