# OCOTILLO FAMILY DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ocotillo Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396957577
- **Authorized official:** GIRIJA NADARAJAN (MANAGING MEMBER OWNER)
- **Authorized official phone:** (480) 802-8686

## Contact information

- **Practice address:** 995 E OCOTILLO RD, SUITE \#3, CHANDLER, AZ 85249-3111
- **Practice address phone:** (480) 802-8686
- **Practice address fax:** (480) 802-8688
- **Mailing address:** 995 E OCOTILLO RD, SUITE \#3, CHANDLER, AZ 85249-3111
- **Mailing address phone:** (480) 802-8686
- **Mailing address fax:** (480) 802-8688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1886702 | UCCI | AZ |
| 01 | — | 78195 | DHA | AZ |