OrganizationActive
East Valley Periodontics
NPI 1063649192 · Periodontics · Mesa, AZ
Provider details
- NPI number
- 1063649192
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Penny Mckinney, Office Manager(480) 218-7590
- License
- 7751 (AZ)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
6755 E Superstition Springs Blvd
Ste. 102
Mesa, AZ 85206-4373
Phone: (480) 218-7590
Fax: (480) 218-2247
Approximate (ZIP-level) locationGet directions
Mailing address
6755 E Superstition Springs Blvd
Mesa, AZ 85206-4373
Registry dates
- Enumerated
- 2009-06-16
- Last updated
- 2009-06-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.