EPIPHANY DERMATOLOGY OF ARIZONA, LLC


Address: 7767 W Deer Valley Rd, Suite 140, Peoria, AZ 85382-2103
Phone: 6234873003

EPIPHANY DERMATOLOGY OF ARIZONA, LLC (NPI# 1457465858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457465858
Entity Type Organization
Organization Name EPIPHANY DERMATOLOGY OF ARIZONA, LLC
Practice Address 7767 W Deer Valley Rd
Suite 140
Peoria
AZ 85382-2103
Mailing Address 6601 Vaught Ranch Rd Ste 200
Austin
TX 78730-2309
Practice Telephone 6234873003
Practice Fax Number 6234870952
Mailing Telephone 5126280465
Mailing Fax Number 5126280468
Enumeration Date 2006-08-19
Last Update Date 2018-12-13
Authorized Official Name MR. GHEORGHE PUSTA (CEO)
Authorized Official Telephone 5126280465
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ MEDICARE GROUP PTAN 63140 01

Office Location

Street Address 7767 W DEER VALLEY RD
SUITE 140
City PEORIA
State AZ
Zip Code 85382-2103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154757995 Andrew G Hicks Physician Assistant 7767 W Deer Valley Rd, Peoria, AZ 85382-2103 2013-09-25
1366709578 Megan Yanno Physician Assistant 7767 W Deer Valley Rd, 140, Peoria, AZ 85382-2103 2012-04-12

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1205435146 Arizona Ot Solutions LLC Occupational Therapist 7450 W. Karen Lee Lane, Peoria, AZ 85382 2020-10-21
1497380604 Idream Psychiatry Psychiatry & Neurology 8194 West Deer Valley Rd, 106-516, Peoria, AZ 85382 2020-03-08
1770137648 Stefan Cseh Occupational Therapy Assistant 8765 W Keiton Lane #116, Peona, AZ 85382 2019-07-30
1174177422 Assyrian Cultural Foundation of Arizona Homemaker 9163 West Union Hills Drive, Suite 114 and 115, Peoria, AZ 85382 2019-07-25
1073072765 Darby Shipman Physical Therapist 8685 W. Union Hills Drive, Peoria, AZ 85382 2019-03-13
1811483480 Kimberly Ann Cochran Nurse Practitioner 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 2018-07-07
1831693514 Summa Health Care, PC Family Medicine 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 2018-03-19
1497258727 Nkemdirim Obiora Nurse Practitioner 7853 West Lone Cactus Drive, Peoria, AZ 85382 2018-03-13
1851893721 Alyssa Michelle Bauman Registered Nurse 20283 N Lake Pleasant Rd Ste 112, Peoria, AZ 85382 2018-03-06
1043767106 Jason Mcaddley Pharmacist 9425 West Union Hills Drive, Peoria, AZ 85382 2016-09-07
Find all providers in zip 85382

Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659667954 Katherine Ann Beaudry Dermatology 5401 N Knoxville Ave Ste 115, Peoria, IL 61614-5095 2011-06-24
1366753865 Douglas Heiner Dermatology 14155 N 83rd Ave Ste 110, Peoria, AZ 85381-5640 2010-06-30
1902096928 Joshua Bradley Kentosh Dermatology 4909 N. Glen Park Place, Peoria, IL 61614-4676 2007-07-26
1336341650 Julie Diane Jacobs Dermatology 7767 W Deer Valley Road, Peoria, AZ 85382 2007-05-31
1902852320 Keith J Haar Dermatology 7767 W. Deer Valley Rd, Peoria, AZ 85382-2103 2006-05-26
1184600884 North Valley Dermatology LLC Dermatology 14155 N 83rd Ave, Suite 110, Peoria, AZ 85381-5639 2005-12-15
1407830805 Rosemary Theresa Depaoli Dermatology 7767 W Deer Valley Rd Ste 140, Peoria, AZ 85382-2103 2005-11-30
1548806276 Arizona Mobile Dermatology and Wound Care Plc Dermatology 7615 W Thunderbird Rd Ste 105, Peoria, AZ 85381-6083 2019-11-18
1942681655 Rachel Lauren Cetta Dermatology 14155 N 83rd Ave Ste 110, Peoria, AZ 85381-5640 2015-06-18
1992118434 Dane Hill Dermatology 7767 W Deer Valley Rd Ste 140, Peoria, AZ 85382-2103 2014-06-03
Find all providers in PEORIA

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City PEORIA
Zip Code 85382

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Dataset Information

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.

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