# PARADISE RIDGE FAMILY DENTISTRY 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
- **Other names:** Paradise Ridge Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841050267
- **Authorized official:** RODNEY CLARK TILLEY (OWNER/GM)
- **Authorized official phone:** (602) 695-4192

## Contact information

- **Practice address:** 15433 N TATUM BLVD STE 200, PHOENIX, AZ 85032-4228
- **Practice address phone:** (602) 755-4691
- **Mailing address:** 16627 S LINDSAY RD, GILBERT, AZ 85295-1501
- **Mailing address phone:** (602) 695-4192

## Taxonomy

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

## Other

- **Enumeration date:** 03/21/2024
- **Last updated:** 03/21/2024