OrganizationActive
Dental Depot 91st & Indian School, PLLC
NPI 1073204012 · General Practice Dentistry · Phoenix, AZ
Provider details
- NPI number
- 1073204012
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Glenn Ashmore, Owner / Ceo(405) 945-8941
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4115 N. 91st Ave.
Phoenix, AZ 85037
Phone: (623) 604-6723
Fax: (480) 741-8850
Street-level locationGet directions
Mailing address
2828 Nw 30th St
Oklahoma City, OK 73112-7404
Registry dates
- Enumerated
- 2023-05-19
- Last updated
- 2025-05-30
- Certified
- 2025-05-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.