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LYDIAN DENTAL QUEEN CREEK, LLC
NPI 1972097392
Dentist - General Practice in Queen Creek, AZ

Active since June 19, 2018
21295 S ELLSWORTH LOOP RD STE 103, QUEEN CREEK, AZ 85142(480) 445-9188(480) 526-8177 Get Directions Write a Review

NPPES record last updated: June 19, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lydian Dental Queen Creek, Llc NPPES

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

LYDIAN DENTAL QUEEN CREEK, LLC (NPI 1972097392) is a healthcare organization registered as a general practice in Queen Creek, Arizona and active in the NPI registry since June 2018. The organization lists Pam D Buckhanan, Insurance Coordinator, as its authorized official.

NPPES Registry Identity

NPI1972097392
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameLYDIAN DENTAL QUEEN CREEK, LLC
Location Address21295 S ELLSWORTH LOOP RD STE 103Queen Creek, AZ 85142-9867
Mailing Address21295 S Ellsworth Loop Rd Ste 103Queen Creek, AZ 85142-9867 · (480) 445-9188 · Fax (480) 526-8177
Phone(480) 445-9188
Fax(480) 526-8177
Organization SubpartNo
Authorized OfficialPam D BuckhananInsurance Coordinator · (480) 445-9188
Enumeration DateJune 19, 2018
✔ NPI 1972097392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in AZ · D009270
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.
21295 S ELLSWORTH LOOP RD STE 103, Queen Creek, AZ 85142
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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

Other Providers at the Same Location NPPES 2

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

SUNSHINE LEE DMD
Dentist
21295 S ELLSWORTH LOOP RD STE 103
QUEEN CREEK, AZ 85142
Maricopa County (480) 445-9188
IT'S YOUR TIME DENTAL
Dentist (General Practice)
21295 S ELLSWORTH LOOP RD STE 103
QUEEN CREEK, AZ 85142
Maricopa County (480) 571-9347

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 Lydian Dental Queen Creek, LLC's NPI number?

The NPI number for Lydian Dental Queen Creek, LLC is 1972097392. It was assigned to this organization in the NPPES registry on June 19, 2018.

Where is Lydian Dental Queen Creek, LLC located?

Lydian Dental Queen Creek, LLC is located at 21295 S Ellsworth Loop Rd Ste 103, Queen Creek, AZ 85142. The listed phone number is (480) 445-9188.

What is Lydian Dental Queen Creek, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Lydian Dental Queen Creek, LLC was last updated on June 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.