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

East Valley Periodontics

Organization Periodontics · NPI 1063649192

East Valley Periodontics is a Periodontics in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2009.

Licensed in
AZ
In the registry since
2009
Specialties on file
2

Practice location Address checks out

6755 E Superstition Springs Blvd Ste 102
Mesa, AZ 85206-4373
Phone: (480) 218-7590
Fax: (480) 218-2247
Show map & directions

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

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 2619 (AZ)
Periodontics Taxonomy 1223P0300X · Licence 7751 (AZ)

Record details

NPI number1063649192
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Penny McKinney — Office Manager · (480) 218-7590
NPI enumeratedJune 16, 2009
Last updated in NPPESJune 16, 2009
Mailing address6755 E Superstition Springs Blvd, Ste. 102, Mesa, AZ 85206-4373

Other providers in Mesa