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

Fiesta Kidtastic, LLC

Organization Pediatric Dentistry · NPI 1215281688

Fiesta Kidtastic, LLC is a Pediatric Dentistry in Mesa, Arizona. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1303 S Longmore Ste 1
Mesa, AZ 85202-9607
Phone: (480) 648-4037
Fax: (480) 696-5505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1215281688
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jaime Johnson — Controller · (480) 648-4037
Other names Fiesta Kidtastics
NPI enumeratedNovember 6, 2012
Last updated in NPPESDecember 6, 2013
Mailing address4704 E Southern Ave, Mesa, AZ 85206-2737

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