Provider Demographics
NPI:1063577393
Name:VANDER SCHAAF PC
Entity type:Organization
Organization Name:VANDER SCHAAF PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:D
Authorized Official - Last Name:VANDER SCHAAF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-994-5225
Mailing Address - Street 1:7301 E THOMAS ROAD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7215
Mailing Address - Country:US
Mailing Address - Phone:480-994-5225
Mailing Address - Fax:480-947-8866
Practice Address - Street 1:7301 E THOMAS ROAD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7215
Practice Address - Country:US
Practice Address - Phone:480-994-5225
Practice Address - Fax:480-947-8866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43981223G0001X
AZ44261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
826546OtherUNITED CONCORDIA