# FAIRWAY DENTAL AZ PLLC

> 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:** 1609730779
- **Authorized official:** DR. JUSTIN EWELL D.M.D. (OWNER/DENIST)
- **Authorized official phone:** (623) 428-1808

## Contact information

- **Practice address:** 250 VILLAGE PARKWAY, SUITE 203/204, LITCHFIELD PARK, AZ 85340
- **Practice address phone:** (623) 428-1808
- **Practice address fax:** (623) 428-0690
- **Mailing address:** 250 VILLAGE PARKWAY, SUITE 205, LITCHFIELD PARK, AZ 85340
- **Mailing address phone:** (623) 428-1808
- **Mailing address fax:** (623) 428-0690

## Taxonomy

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

## Other

- **Enumeration date:** 12/12/2025
- **Last updated:** 12/22/2025