DEAN D ETTINGER MD PC (NPI# 1689925711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689925711 |
| Entity Type | Organization |
| Organization Name | DEAN D ETTINGER MD PC |
| Practice Address |
155 Calle Portal Suite 200 Sierra Vista AZ 85635-2900 |
| Practice Telephone | 5204580660 |
| Practice Fax Number | 5204589550 |
| Mailing Telephone | 5204580660 |
| Mailing Fax Number | 5204589550 |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2012-09-28 |
| Authorized Official Name | DR. DEAN D ETTINGER (OWNER) |
| Authorized Official Telephone | 5204580660 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
12142 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
155 CALLE PORTAL SUITE 200 |
| City | SIERRA VISTA |
| State | AZ |
| Zip Code | 85635-2900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235103508 | Kathleen Jane Vedock | Pediatrics | 155 Calle Portal, Suite 700, Sierra Vista, AZ 85635-2900 | 2006-02-14 |
| 1205381472 | Lakeisha Love | Nurse Practitioner | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2016-08-17 |
| 1710342043 | Kerstin P Hurley | Psychologist | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-12-31 |
| 1316318728 | Kerstin P. Hurley, Phd | Psychologist | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-10-12 |
| 1417331711 | Chiricahua Community Health Centers, Inc | Clinic/Center | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2015-07-16 |
| 1033532163 | Akdhc, LLC | Internal Medicine | 155 Calle Portal, Suite 400, Sierra Vista, AZ 85635-2900 | 2014-01-24 |
| 1760781017 | Dixie Jean Millican | Nurse Practitioner | 155 Calle Portal, Suite 200, Sierra Vista, AZ 85635-2900 | 2011-03-24 |
| 1821309089 | Chiricahua Community Health Centers, Inc | Clinic/Center | 155 Calle Portal, Suite 700, Sierra Vista, AZ 85635-2900 | 2010-06-23 |
| 1649595174 | Amy Christine Clark | Family Medicine | 155 Calle Portal, Suite 300, Sierra Vista, AZ 85635-2900 | 2010-03-26 |
| 1790961167 | Carnett Clinic, LLC | Family Medicine | 155 Calle Portal, Suite 600, Sierra Vista, AZ 85635-2900 | 2008-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740640 | Taylor Anne Phelps | Student in an Organized Health Care Education/Training Program | Haven of Sierra Vista LLC, 660 Coronado Drive, Sierra Vista, AZ 85635 | 2020-05-06 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1518515212 | Canyon Vista Dental | Dentist | 1993 S Frontage Road, Suite 208, Sierra Vista, AZ 85635 | 2019-08-27 |
| 1225697402 | Kristine Vincent Cruz Angeles | Dentist | 115 Calle Poral, Sierra Vista, AZ 85635 | 2019-06-11 |
| 1700397411 | Vivian Ryu | Social Worker | 2300 E Fry Blvd, #3822, Sierra Vista, AZ 85635 | 2017-10-20 |
| 1750806758 | Rosemary Nduta Kagwanja | Technician | 425 Bernini Avenue, N/a, Sierra Vista, AZ 85635 | 2017-08-10 |
| 1093245789 | Akdhc, LLC | Internal Medicine | 5555 Mesa Verde Dr, Suite 100, Sierra Vista, AZ 85635 | 2017-06-14 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1629506811 | Andrew Tang | Student in an Organized Health Care Education/Training Program | 5700 Arizona 90, Sierra Vista, AZ 85635 | 2017-06-01 |
| 1194259382 | Walik Hargett | Contractor | 800 N. Lenzner Ave Apt 776b, Sierra Vista, AZ 85635 | 2017-04-14 |
| Find all providers in zip 85635 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114271798 | Kristen Marie Buchanan | Pediatrics | 4700 N 51st Ave Ste 4, Phoenix, AZ 85031-1237 | 2012-11-02 |
| 1992060222 | Patti J. Perry, M.d. PC | Pediatrics | 1832 S. 8th Avenue, Yuma, AZ 85364 | 2012-07-12 |
| 1952626053 | Joseph King Hindman | Pediatrics | 8375 Koch Field Rd, Flagstaff, AZ 86004-1255 | 2010-03-31 |
| 1669679098 | Stefanie Ann Workman | Pediatrics | 2929 N Power Rd, Suite 101, Mesa, AZ 85215-1745 | 2007-06-29 |
| 1295930980 | Mary Ellen Rimsza | Pediatrics | 518 S 3rd St, Phoenix, AZ 85004-2506 | 2007-06-20 |
| 1255544987 | Jeffrey Siegel | Pediatrics | 10200 N 92nd St Ste 150, Scottsdale, AZ 85258-4535 | 2007-05-08 |
| 1629296249 | Good Night Pediatrics East Valley PC | Pediatrics | 1452 N Higley Rd, Gilbert, AZ 85234-1600 | 2007-04-20 |
| 1508957101 | John Curley | Pediatrics | 4434 N 12th St, Phoenix, AZ 85014-4507 | 2006-09-27 |
| 1780775395 | Shannon Forshey | Pediatrics | 4434 N 12th Street, Phoenix, AZ 85014-1101 | 2006-09-27 |
| 1194816702 | Brad Golner | Pediatrics | 4735 E Union Hills Dr, Phoenix, AZ 85050-3362 | 2006-09-27 |
| Find all providers with the same taxonomy | ||||
| City | SIERRA VISTA |
| Zip Code | 85635 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.