OrganizationActive
Fiesta Kidtastic, LLC
NPI 1215281688 · Pediatric Dentistry · Mesa, AZ
Fiesta Kidtastic, LLC is a Pediatric Dentistry organization in Mesa, AZ (NPI 1215281688).
Provider details
- NPI number
- 1215281688
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Jaime Johnson, Controller(480) 648-4037
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
1303 S Longmore Ste 1
Mesa, AZ 85202-9607
Phone: (480) 648-4037
Fax: (480) 696-5505
Street-level locationGet directions
Mailing address
4704 E Southern Ave
Mesa, AZ 85206-2737
Other names (DBA / former)
- Doing business as
- Fiesta Kidtastics
Registry dates
- Enumerated
- 2012-11-06
- Last updated
- 2013-12-06
Frequently asked questions
- What is Fiesta Kidtastic, LLC's NPI number?
- Fiesta Kidtastic, LLC's National Provider Identifier (NPI) is 1215281688, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fiesta Kidtastic, LLC?
- Fiesta Kidtastic, LLC is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Fiesta Kidtastic, LLC located?
- Fiesta Kidtastic, LLC's practice location on file with NPPES is 1303 S Longmore Ste 1, Mesa, AZ 85202-9607.
- What is Fiesta Kidtastic, LLC's phone number?
- The practice phone number listed in the NPPES registry for Fiesta Kidtastic, LLC is (480) 648-4037.
- Who is the authorized official for Fiesta Kidtastic, LLC?
- The authorized official listed on Fiesta Kidtastic, LLC's NPPES record is Jaime Johnson, Controller. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fiesta Kidtastic, LLC's NPI active?
- Yes — Fiesta Kidtastic, LLC's NPI (1215281688) is active in the NPPES registry as of the last update on 2013-12-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.