Provider Demographics
NPI:1427439116
Name:KIRCHHOFER, JAYSON ARTHUR (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:JAYSON
Middle Name:ARTHUR
Last Name:KIRCHHOFER
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6945 E SAHUARO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6722
Mailing Address - Country:US
Mailing Address - Phone:480-998-7500
Mailing Address - Fax:
Practice Address - Street 1:6945 E SAHUARO DR STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6722
Practice Address - Country:US
Practice Address - Phone:480-998-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0105181223S0112X
FLDRP#14561223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty