Bryce E Slack
Dentist - General Practice • Glendale, AZ
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Bryce Slack has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Bryce Slack was a registered Dentist - General Practice practicing in Glendale, AZ. Throughout an active medical career spanning 6 years, Bryce Slack provided care at the practice location at 5400 W NORTHERN AVE STE 202 until profile deactivation on 2023-04-17.
Practice Location & Contact Primary Location
5400 W Northern Ave Ste 202
Glendale, AZ 853011591
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Glendale, AZ
Practicing in Glendale, AZ (2600 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
CMS Verified: 2025-02-20NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
NUCC Taxonomy Code: 1223G0001X
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist - General Practice
Doctor of Dental Medicine
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Registered at 5400 W NORTHERN AVE STE 202, GLENDALE, AZ 853011591 (Tel: 6235005793)
Registered at 9169 W ALEX AVE, PEORIA, AZ 853828344 (Tel: 4357737175)
Registered at 101 S ADAIR ST, PRYOR, OK 743613625 (Tel: 9188257111)
Registered at 2007 E 133RD ST S, BIXBY, OK 740081200 (Tel: 4357737175)
Recorded as BRYCE SLACK
Dentist (License #6979 in OK)
Record deactivated on April 17, 2023
NPI status registered as active in NPPES database
Registered at 101 S ADAIR ST, PRYOR, OK 743613625 (Tel: 9188257111)
Registered at 2007 E 133RD ST S, BIXBY, OK 740081200 (Tel: 4357737175)
Recorded as BRYCE SLACK
Dentist (License #6979 in OK)
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
9169 W Alex Ave
Peoria, AZ 853828344
Phone: 4357737175
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