# DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM

> 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
- **Parent organization:** DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
- **Other names:** YAHC Dental Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578618831
- **Legal business name:** DHEW IND HLTH SV HLTH SVS & MNTL HLTH ADM
- **Authorized official:** LAURA A TILLMAN (CMO)
- **Authorized official phone:** (602) 263-1674

## Contact information

- **Practice address:** 2121 WEST RESERVATION LOOP ROAD, CAMP VERDE, AZ 86322-8412
- **Practice address phone:** (602) 263-1200
- **Practice address fax:** (602) 263-1618
- **Mailing address:** PO BOX 95460, CLEVELAND, OH 44101-0033
- **Mailing address phone:** (602) 581-6088
- **Mailing address fax:** (602) 263-1619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | — |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 05/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 812869 | — | AZ |