# SCOTTSDALE IMPLANT AND COSMETIC DENTISTRY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** VALLEY IMPLANT CENTERS PLLC
- **Other names:** Scottsdale Implant and Cosmetic Dentistry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1134616378
- **Legal business name:** VALLEY IMPLANT CENTERS PLLC
- **Authorized official:** MRS. PORTIA L FREDSTRUP (OWNER)
- **Authorized official phone:** (602) 303-5827

## Contact information

- **Practice address:** 4910 E GREENWAY RD STE 7, SCOTTSDALE, AZ 85254-1653
- **Practice address phone:** (480) 200-3453
- **Mailing address:** 7547 S FRONTIER ST, GILBERT, AZ 85298-0130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | D009808 | AZ | Yes |

## Other

- **Enumeration date:** 04/13/2018
- **Last updated:** 06/16/2018