# DHHS IHS PHOENIX AREA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DHHS IHS PHOENIX AREA
- **Other names:** Whiteriver Service Unit Dental Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144347501
- **Legal business name:** DHHS IHS PHOENIX AREA
- **Authorized official:** MICHELLE MARTINEZ FNP (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (928) 338-4911

## Contact information

- **Practice address:** 200 WEST HOSPITAL WAY, WHITERIVER, AZ 85941-0860
- **Practice address phone:** (928) 338-4911
- **Practice address fax:** (928) 338-5508
- **Mailing address:** PO BOX 860, 200 WEST HOSPITAL DRIVE, WHITERIVER, AZ 85941-0860
- **Mailing address phone:** (928) 338-4911
- **Mailing address fax:** (928) 338-5508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | — |
| 1223D0001X | Public Health Dentistry | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | — |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/23/2007
- **Last updated:** 12/27/2011