Provider Demographics
NPI:1215661194
Name:UNTVA PLLC
Entity type:Organization
Organization Name:UNTVA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FOISY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-622-5123
Mailing Address - Street 1:15294 W BROOKSIDE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2446
Mailing Address - Country:US
Mailing Address - Phone:623-376-7400
Mailing Address - Fax:
Practice Address - Street 1:15294 W BROOKSIDE LN STE 100
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2446
Practice Address - Country:US
Practice Address - Phone:623-376-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty