OrganizationActive
Canyon Modern Dentistry, LLP
NPI 1194021170 · General Practice Dentistry · Surprise, AZ
Provider details
- NPI number
- 1194021170
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- James Mallory, Owner Doctor(623) 546-8400
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
17081 W Greenway Rd Ste 121
Surprise, AZ 85388-9612
Phone: (623) 546-8400
Fax: (623) 214-5830
Street-level locationGet directions
Mailing address
2860 Michelle Drive 2nd Floor
Irvine, CA 92606
Other names (DBA / former)
- Doing business as
- Canyon Modern Dentistry
Registry dates
- Enumerated
- 2011-02-08
- Last updated
- 2011-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.