# AZ FAMILY DENTAL - THUNDERBIRD 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
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518684042
- **Authorized official:** DR. MATTHEW PARKER D.M.D (DOCTOR/ OWNER)
- **Authorized official phone:** (602) 715-6378

## Contact information

- **Practice address:** 1820 W THUNDERBIRD RD STE 2, PHOENIX, AZ 85023-6300
- **Practice address phone:** (623) 303-8089
- **Practice address fax:** (623) 321-9488
- **Mailing address:** 1610 E MCLELLAN RD, MESA, AZ 85203-3944
- **Mailing address phone:** (623) 303-8089
- **Mailing address fax:** (623) 321-9488

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2022
- **Last updated:** 10/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1336400472 | OWNER NPI | AZ |