Provider Demographics
NPI:1104869239
Name:FOX, JOSEPH R (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:FOX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7921 W PATRICK LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-1605
Mailing Address - Country:US
Mailing Address - Phone:623-362-9888
Mailing Address - Fax:
Practice Address - Street 1:FOX FAMILY DENTAL
Practice Address - Street 2:10147 W. GRAND AVE. SUITE A3
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3435
Practice Address - Country:US
Practice Address - Phone:623-523-0290
Practice Address - Fax:623-523-0294
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ51251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0016083OtherASSURANT FACILITY NO.
AZ0535OtherEMPLOYER DENTAL SVC'S
AZ30796OtherTOTAL DENTAL ADMIN. DHMO
AZ756418OtherUNITED CONCORDIA ID NO.
AZ44310OtherPACIFICARE DENTAL DHMO
AZ987729OtherAHCCCS