Organization
PARADISE VALLEY DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY J NESTLERODE DDS (DENTIST - OWNER)
(480) 483-8067
Entity
Organization
Contact information
Practice address
6865 E. BECKER LANE #100, SCOTTSDALE, AZ 85254
(480) 483-8067
(480) 483-8471
Mailing address
6865 E. BECKER LANE #100, SCOTTSDALE, AZ 85254
(480) 483-8067
(480) 483-8471
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AZ4495
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40649
UNITED HEALTHCARE
AZ
01
—
410439
UNITED CONCORDIA
AZ
Enumeration date
01/31/2007
Last updated
03/07/2023
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