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

Greenway 40 LLC

Organization Dentist · NPI 1174810840

Greenway 40 LLC is a Dentist in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2011.

Licensed in
AZ
In the registry since
2011
Specialties on file
2
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

4022 E Greenway Rd Ste 13
Phoenix, AZ 85032-4797
Phone: (602) 595-1115
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence AZ3740 (AZ)
Dentist Taxonomy 122300000X · Licence AZ4044 (AZ)

Record details

NPI number1174810840
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Velasco — Co-Owner · (602) 595-1115
Other names Age Defying Dentistry, Phoenix
NPI enumeratedJuly 1, 2011
Last updated in NPPESAugust 2, 2012
Mailing address4022 E Greenway Rd, Ste 13, Phoenix, AZ 85032-4799

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