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

Desert Ridge Implant & Oral Surgery PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1588960512

Desert Ridge Implant & Oral Surgery PC is an Oral and Maxillofacial Surgery (Dentist) in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2011.

Licensed in
AZ
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

20950 N Tatum Blvd Ste 120
Phoenix, AZ 85050-4200
Phone: (480) 563-3960
Fax: (480) 563-3965
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 5196 (AZ)

Record details

NPI number1588960512
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Matthew Defelice — Owner · (480) 563-3960
NPI enumeratedFebruary 9, 2011
Last updated in NPPESApril 4, 2011
Mailing address20950 N Tatum Blvd, Ste. 120, Phoenix, AZ 85050-4200

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