Bryce E. Slack

General Practice Dentistry · Glendale, AZ

Individual Active NPI Reactivated May 10, 2023

NPI number 1013438100

Practice location

5400 W Northern Ave Ste 202
Glendale, AZ 85301-1591
Phone
(623) 500-5793
Fax
(623) 321-1030

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NPI record

NPI
1013438100
Entity type
Individual (Type 1)
Enumeration date
June 29, 2017
Last updated
February 20, 2025
Certified
February 20, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X D010940 AZ
General Practice Dentistry 1223G0001X 6979 OK

Mailing address

9169 W Alex Ave
Peoria, AZ 85382-8344
Phone
(435) 773-7175

About Bryce Slack

Bryce E. Slack is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 5400 W Northern Ave Ste 202, Glendale, AZ 85301-1591. The NPI number 1013438100 was assigned on June 29, 2017 and the record was last updated on February 20, 2025.

Bryce Slack lists 2 licenses in the registry: #D010940 (AZ) for General Practice Dentistry; #6979 (OK) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Bryce E. Slack?

The NPI number is 1013438100.

What is the phone number of Bryce Slack?

The phone number listed for the practice location is (623) 500-5793.

Where is Bryce Slack located?

5400 W Northern Ave Ste 202, Glendale, AZ 85301-1591.

What is the taxonomy code for Bryce Slack?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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