Provider Demographics
NPI:1487379426
Name:NUSET SCOTTSDALE
Entity type:Organization
Organization Name:NUSET SCOTTSDALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CORY
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DDS
Authorized Official - Phone:303-501-2212
Mailing Address - Street 1:7991 VANCE DR STE A
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2148
Mailing Address - Country:US
Mailing Address - Phone:303-422-2990
Mailing Address - Fax:
Practice Address - Street 1:8800 E RAINTREE DR STE 170
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3961
Practice Address - Country:US
Practice Address - Phone:520-503-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty