# CHOLLA HILLS FAMILY DENTISTRY LLC

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

## Provider details

- **NPI number:** 1417179870
- **Authorized official:** GIRIJA NADARAJAN (MANAGING MEMBER OWNER)
- **Authorized official phone:** (623) 979-6363

## Contact information

- **Practice address:** 7425 W PEORIA AVE, SUITE 102, PEORIA, AZ 85345-5876
- **Practice address phone:** (623) 979-6363
- **Practice address fax:** (623) 334-2301
- **Mailing address:** 7425 W PEORIA AVE, SUITE 102, PEORIA, AZ 85345-5876
- **Mailing address phone:** (623) 979-6363
- **Mailing address fax:** (623) 334-2301

## 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 | — | 1888390 | UCCI | AZ |
| 01 | — | 274044 | DBA | AZ |
| 01 | — | 76287 | DHA | AZ |