PHOENIX PEDIATRIC DENTAL, LLC
NPI 1891875498
Dentist - Pediatric Dentistry in Phoenix, AZ

Q: What is Phoenix Pediatric Dental, LLC's NPI number?

The NPI number for Phoenix Pediatric Dental, LLC is 1891875498. It was assigned to this organization in the NPPES registry on October 17, 2006.

Q: What is Phoenix Pediatric Dental, LLC's specialty?

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

Active since October 17, 2006

6750 N 19TH AVE, PHOENIX, AZ 85015(602) 242-5741(602) 242-5742 Get Directions Write a Review

NPPES record last updated: December 23, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Phoenix Pediatric Dental, Llc NPPES

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

PHOENIX PEDIATRIC DENTAL, LLC (NPI 1891875498) is a healthcare organization registered as a pediatric dentistry in Phoenix, Arizona and active in the NPI registry since October 2006. The organization lists Luz Pacheco, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1891875498

Entity TypeOrganization

Primary Taxonomy1223P0221X

Legal Business NamePHOENIX PEDIATRIC DENTAL, LLC

Location Address6750 N 19TH AVEPhoenix, AZ 85015-1127

Mailing Address6750 N 19th AvePhoenix, AZ 85015-1127 · (602) 242-5741 · Fax (602) 242-5742

Phone(602) 242-5741

Fax(602) 242-5742

Organization SubpartNo

Authorized OfficialLuz PachecoBusiness Manager · (602) 242-5741

Enumeration DateOctober 17, 2006

Last NPPES UpdateDecember 23, 2014

✔ NPI 1891875498 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.

6750 N 19TH AVE, Phoenix, AZ 85015

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Other Identifiers 6

Medicaid450924AZ

Medicaid627562AZ

Medicaid409926AZ

Medicaid883737AZ

Medicaid570475AZ

Medicaid796862AZ

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

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

Other Providers at the Same Location NPPES 9

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

DR. JARED MICHAEL SORENSEN D.D.S.

Dentist (Pediatric Dentistry)