# SURPRISE ENDO PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Surprise Endodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285432518
- **Authorized official:** RYNE JACKSON DMD, MSD (OWNER)
- **Authorized official phone:** (480) 353-6476

## Contact information

- **Practice address:** 15294 W BROOKSIDE LN STE 100, SURPRISE, AZ 85374-2446
- **Practice address phone:** (623) 376-7400
- **Mailing address:** 15294 W BROOKSIDE LN STE 100, SURPRISE, AZ 85374-2446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | Yes |
| 1223E0200X | Endodontics | — | — | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/04/2025
- **Last updated:** 03/04/2025