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

Pepsquad PLLC

Organization Dentist · NPI 1487228961

Pepsquad PLLC is a Dentist in Mesa, Arizona. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5215 E Southern Ave
Mesa, AZ 85206-2777
Phone: (509) 823-4480
Fax: (509) 823-4490
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X
Orthodontics and Dentofacial Orthopedics Dentistry Taxonomy 1223X0400X
Denturist Taxonomy 122400000X

Record details

NPI number1487228961
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derek Thompson — Owner · (509) 823-4480
NPI enumeratedMay 18, 2021
Last updated in NPPESMay 18, 2021
Certification dateMay 18, 2021
Mailing address4309 W Nob Hill Blvd, Yakima, WA 98908-3971

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