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Provider Information for 1912067596

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Other Name:   REBECCA DORF
Gender: FEMALE

Individual NPI: 1912067596

Calendar   Last Updated:  2011-07-13
  Certification Date: 


Name Value
NPI 1912067596
Enumeration Date 2006-12-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 8046 N 2ND DR
PHOENIX, AZ 85021-5607
United States

Phone: 732-740-7465 | Fax:
View Map External Link
Primary Practice Address 2620 S 83RD AVE #104
PHOENIX, AZ 85043-7203
United States

Phone: 623-936-6665 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice AZ D7361
No 1223G0001X - Dentist General Practice NY 039523-1
No 1223G0001X - Dentist General Practice NJ 14922