Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

1801 Southern Vista Dental Care

Organization Dentist · NPI 1023102183

1801 Southern Vista Dental Care is a Dentist in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2006.

Licensed in
AZ
In the registry since
2006
Specialties on file
3

Practice location Address checks out

1801 E Southern Ave Ste 103
Mesa, AZ 85204-5258
Phone: (480) 892-9000
Fax: (480) 926-0545
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 6591 (AZ)
Dentist Taxonomy 122300000X · Licence 6283 (AZ)
Dentist Taxonomy 122300000X · Licence 2561 (AZ)

Record details

NPI number1023102183
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elwynn Caffall — Direct Owner · (480) 892-9000
Other names Southern Vista Dental Care
NPI enumeratedOctober 3, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1801 E Southern Ave, Suite 103, Mesa, AZ 85204-5258

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