is a Pediatric Dental Clinic in Glendale, Arizona. This organization is also known as sub part of Ivy 2 Dental Pllc. It is located at 5144 W Olive Ave, Glendale, AZ and its contact number is 623-939-9944. The authorized person for is Umar M Imtiaz
who is Associate Provider of the clinic and their contact number is 623-444-9999. The primary license number for is 7256 (Pediatric Dentistry) in Arizona. 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:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Pediatric Dentistry
Clinic Address:
5144 W Olive Ave, Glendale, Arizona, 85302-4209
Phone:
623-939-9944
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:
Umar M Imtiaz
Position:
Associate Provider
Contact Number:
623-444-9999
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 clinic are as mentioned below.
NPI Number:
1306372503
Parent Organization:
Ivy 2 Dental Pllc
NPI Enumeration Date:
08 May, 2017
NPI Last Update On:
20 Jul, 2021
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
7256
Arizona
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
274792
Medicaid
Arizona
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
5144 W Olive Ave, Glendale, Arizona
Zip:
85302-4209
Phone Number:
623-939-9944
Patients can reach at 5144 W Olive Ave, Glendale, Arizona or can call to book an appointment on 623-939-9944. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.