Fiesta Kidtastic, Llc is a Pediatric Dental Clinic in Mesa, Arizona. It is located at 1303 S Longmore Ste 1, Mesa, AZ and its contact number is 480-648-4037. The authorized person for Fiesta Kidtastic, Llc is Ms. Jaime Johnson
who is Controller of the clinic and their contact number is 480-648-4037.
Fiesta Kidtastic, Llc Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Fiesta Kidtastic, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Fiesta Kidtastic, Llc |
| Specialization: | Pediatric Dentistry |
| Clinic Address: | 1303 S Longmore Ste 1, Mesa,
Arizona, 85202-9607 |
| Phone: | 480-648-4037 |
| Fax: | 480-696-5505 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Ms. Jaime Johnson |
| Position: | Controller |
| Contact Number: | 480-648-4037 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Fiesta Kidtastic, Llc clinic are as mentioned below.
| NPI Number: | 1215281688 |
| NPI Enumeration Date: | 06 Nov, 2012 |
| NPI Last Update On: | 06 Dec, 2013 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Fiesta Kidtastic, Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pediatric Dentistry | | | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Fiesta Kidtastic, Llc
4704 E Southern Ave,
Mesa, Arizona |
| Zip: | 85206-2737 |
| Phone Number: | 480-648-4037 |
| Fax Number: | 480-696-5505 |
Patients can reach Fiesta Kidtastic, Llc at
1303 S Longmore Ste 1, Mesa, Arizona or can
call to book an appointment on 480-648-4037.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.