AZ DERMATOLOGY (NPI# 1962737965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1962737965 |
Entity Type | Organization |
Organization Name | AZ DERMATOLOGY |
Practice Address |
21300 N John Wayne Pkwy Suite 112 Maricopa AZ 85139-8979 |
Mailing Address |
1821 N Trekell Rd Suite 5 Casa Grande AZ 85122-1705 |
Practice Telephone | 5203742462 |
Practice Fax Number | 5203742467 |
Mailing Telephone | 5203742462 |
Mailing Fax Number | 5203742467 |
Enumeration Date | 2009-10-08 |
Last Update Date | 2009-10-08 |
Authorized Official Name | DR. JAYSHRI GAMOTH (OWNER) |
Authorized Official Telephone | 5203742462 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | 36353 | AZ | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235464231 | Az Dermatology | Specialist | 1840 W Apache Trl, Apache Junction, AZ 85120-3728 | 2009-10-08 |
Street Address |
21300 N JOHN WAYNE PKWY SUITE 112 |
City | MARICOPA |
State | AZ |
Zip Code | 85139-8979 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336125731 | Andrew D Schatzki | Family Medicine | 21300 N John Wayne Pkwy, Ste 123, Maricopa, AZ 85239-8979 | 2005-12-16 |
1508313602 | Atos Dermatopathology Pllc | Dermatology | 21300 N John Wayne Pkwy, #116, Maricopa, AZ 85139-8979 | 2016-09-07 |
1134673932 | Sld LLC | Dentist | 21300 N John Wayne Pkwy, Ste 108, Maricopa, AZ 85139-8979 | 2016-08-09 |
1396197067 | Garrett Johnson | Physical Therapist | 21300 N John Wayne Pkwy, Suite 107, Maricopa, AZ 85139-8979 | 2016-07-06 |
1780040832 | Arizona Associates In Dentistry PC | Dentist | 21300 N John Wayne Pkwy, Suite 128, Maricopa, AZ 85139-8979 | 2016-01-05 |
1790181543 | Brittany Johnson | Physician Assistant | 21300 N John Wayne Pkwy, Suite 123, Maricopa, AZ 85139-8979 | 2014-11-06 |
1922432632 | Akdhc, LLC | Internal Medicine | 21300 N John Wayne Pkwy, Suite 116, Maricopa, AZ 85139-8979 | 2013-08-29 |
1720306459 | Theresa L Bess | Nurse Practitioner | 21300 N John Wayne Pkwy, Suite 121, Maricopa, AZ 85139-8979 | 2010-05-05 |
1023347150 | Southwestern Pediatrics LLC | Nurse Practitioner | 21300 N John Wayne Pkwy, Ste 109, Maricopa, AZ 85139-8979 | 2009-12-21 |
1659512465 | Az-tech Radiology & Open Mri | Radiology | 21300 N John Wayne Pkwy, Suite 113, Maricopa, AZ 85239-8979 | 2009-03-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538778899 | Star House Bhrf LLC | Clinic/Center | 44796 W Sandhill Road, Maricopa, AZ 85139 | 2020-07-23 |
1578020988 | Dentistry At Maricopa, LLC | Dentist | 20046 N. John Wayne Pkwy, Ste 105, Maricopa, AZ 85139 | 2019-02-22 |
1043732431 | The Hands of Grace | Case Management | 44570 W Sedona Trl, Maricopa, AZ 85139 | 2017-07-07 |
1215466636 | Dustin Jeremy Sowards | Naturopath | 18495 N Miller Way, Maricopa, AZ 85139 | 2017-06-08 |
1871029090 | Carolyn Wanyama | Nursing Home Administrator | 44880 W Portabello Road, Maricopa, AZ 85139 | 2017-05-08 |
1740638758 | Melissa Marie Trulson | Dentist | 44481 W Honeycutt Rd, Suite 109, Maricopa, AZ 85139 | 2016-05-31 |
1093189805 | Community Partners Integrated Healthcare, Inc. | Clinic/Center | 20046 N John Wayne Parkway, Ste 102, Maricopa, AZ 85139 | 2015-11-17 |
1134523079 | Shadale Gillespie | Technician | 45565 W. Rainbow Dr., Maricopa, AZ 85139 | 2014-10-21 |
1578964516 | Community Partners Integrated Healthcare, Inc. | Clinic/Center | 20046 N. John Wayne Parkway, Ste. 106-a, Maricopa, AZ 85139 | 2014-09-09 |
1104238716 | Jared Kenney | Dentist | 21300 N John Wayne Pkwy Ste 114, Maricopa, AZ 85139 | 2014-05-30 |
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Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780041996 | Sylvia White | Specialist | 20966 N Sansom Dr, Maricopa, AZ 85138-5501 | 2016-01-19 |
1376646810 | Hilda Flores-vidal | Specialist | 21300 N. John Wayne Pkwy, Unit 116 Bldg 7, Maricopa, AZ 85139-8978 | 2006-09-07 |
1154605863 | Tori Caley Thompson | Specialist | 44480 W Honeycutt Rd, Suite 106, Maricopa, AZ 85138-2903 | 2011-09-30 |
1649410085 | Brandy Dillahunty | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-25 |
1033359518 | Hazel Leyan Scott I | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-24 |
1669612354 | Maria Isabel Hernandez | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-20 |
1942449657 | Thoa Pham | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-19 |
1396984647 | Renee J Mosel | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-10 |
1447498126 | Alice Valencia | Specialist | 45012 W Honeycutt Ave, Maricopa, AZ 85239-2842 | 2009-02-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
1518576123 | Multi Specialty Physicians Group Inc | Specialist | 8428 E Shea Blvd Ste 101, Scottsdale, AZ 85260-6663 | 2020-07-29 |
1902420698 | Doug S Clouse Md Plc | Specialist | 3636 N Stockton Hill Rd Ste 3, Kingman, AZ 86409-0514 | 2020-05-29 |
1518580869 | Zegarra Hospital and Nursing Home Services Pllc | Specialist | 2182 Hway 95, Bullhead City, AZ 86442-6044 | 2020-05-21 |
1154942829 | Fresh Start Bone and Joint Institue | Specialist | 485 S Watson Rd Ste 103-438, Buckeye, AZ 85326-3452 | 2020-05-04 |
1902462179 | Physician Group of Arizona Inc | Specialist | 4801 E Washington St Ste 200, Phoenix, AZ 85034-2019 | 2019-05-14 |
1447814751 | Carmen Tasse | Specialist | 3260 N Hayden Rd Ste 110, Scottsdale, AZ 85251-6650 | 2019-04-23 |
1790246924 | Mark A Meyers | Specialist | 715 S Beeline Hwy Ste A, Payson, AZ 85541-5344 | 2019-03-29 |
1386113538 | Wound Care Associates LLC | Specialist | 2600 E Southern Ave Ste F2, Tempe, AZ 85282-7626 | 2018-11-16 |
1366920910 | Haleys Designer Wigs | Specialist | 6017 E Mckellips Rd Ste 109, Mesa, AZ 85215-2824 | 2018-08-04 |
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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.