Provider record
Black Canyon City Dentistry LLC
The public CMS NPPES listing for Black Canyon City Dentistry LLC places this Dentist record in Black Canyon City, AZ. The practice address is shown as 34501 S Old Black Canyon City Highway, Black Canyon City, AZ. NPPES also reports a phone number. Verify details before visiting or calling.
National Plan and Provider Enumeration System
CMS NPPES
Reported to NPPES
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We show source-reported CMS NPPES fields.
Confirm details directly with the provider.NPI and status
Source-labeled identifiers and reported record state.
- NPI
- 1639380363
- Entity type
- Organization
- NPPES status
- Reported active
- License status
- Not primary-source verified
Practice location
Practice address and phone as reported in CMS NPPES.
- Address
- 34501 S Old Black Canyon City Highway, Suite 5
Black Canyon City, AZ 85324 - Phone
- (623) 374-0855
Directions
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Taxonomy and source
Specialty taxonomy is source-reported and not a quality or license determination.
- Taxonomy code
- 122300000X
- Specialty
- Dentist
- Source
- CMS NPPES
- Last updated
- July 12, 2026
Record actions
Contact and sources
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