ARIZONA SKIN & DERMATOLOGY, P.C. (NPI# 1619378098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619378098 |
| Entity Type | Organization |
| Organization Name | ARIZONA SKIN & DERMATOLOGY, P.C. |
| Practice Address |
7200 W Bell Rd Suite E103 Glendale AZ 85308-8529 |
| Mailing Address |
8380 W Emile Zola Ave Suite 5116 Peoria AZ 85381-4811 |
| Practice Telephone | 6025294700 |
| Practice Fax Number | 6025294699 |
| Mailing Telephone | 6025294700 |
| Mailing Fax Number | 6025294699 |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2015-01-23 |
| Authorized Official Name | DR. MANNTEJ SRA (CEO) |
| Authorized Official Telephone | 6025294700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE PTAN | Z171303 | 01 |
| Street Address |
7200 W BELL RD SUITE E103 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85308-8529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720946 | James William Shoffer | Podiatrist | 7200 W Bell Rd, E101, Glendale, AZ 85308-8529 | 2005-06-17 |
| 1790166510 | Stacey C. Layman Dds Pllc | Dentist | 7200 W Bell Rd, Suite C3, Glendale, AZ 85308-8529 | 2015-06-17 |
| 1447652201 | Rejuvenight LLC | Clinic/Center | 7200 W Bell Rd, Bldg K Suite 101, Glendale, AZ 85308-8529 | 2014-09-23 |
| 1982005328 | Sun Arizona Medical Group P.C. | Internal Medicine | 7200 W Bell Rd, Suite E103, Glendale, AZ 85308-8529 | 2014-09-04 |
| 1336552140 | Arizona Spine and Pain Specialists LLC | Anesthesiology | 7200 W Bell Rd, Ste F-101, Glendale, AZ 85308 | 2014-06-09 |
| 1548673536 | Arizona Oncology Associates PC | Non-Pharmacy Dispensing Site | 7200 W Bell Rd, Bldg. A, Glendale, AZ 85308-8529 | 2014-06-06 |
| 1528485208 | Kaitlin Bowen | Chiropractor | 7200 W Bell Rd, Suite F-101, Glendale, AZ 85308-8529 | 2014-03-19 |
| 1689006785 | Jasmine Sra | Internal Medicine | 7200 W Bell Rd, Bldg E103, Glendale, AZ 85308-8534 | 2013-07-31 |
| 1013254226 | Jessica K Schreck | Physician Assistant | 7200 W Bell Rd, Bldg A, Glendale, AZ 85308-8529 | 2013-01-08 |
| 1861789802 | Desert Valley Wellness Medical Group, PC | Family Medicine | 7200 W Bell Rd, Suite E-103, Glendale, AZ 85308-8529 | 2011-06-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
| 1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
| 1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
| 1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
| 1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
| 1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
| 1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
| 1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
| Find all providers in zip 85308 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790255313 | Core Dermatology, Pllc | Dermatology | 425 South Cherry Suite 907, Glendale, CO 80246 | 2018-11-26 |
| 1801103114 | Oshin Bojalian, M.d. A Medical Corporation | Dermatology | 633 N Central Ave Ste 310, Glendale, CA 91203-1821 | 2010-09-08 |
| 1417279068 | Ryan A. Stevens | Dermatology | 18699 N 67th Ave Ste 220, Glendale, AZ 85308 | 2010-02-24 |
| 1164570180 | Justine Hyoju Park | Dermatology | 435 Arden Ave Ste 435, Glendale, CA 91203-4044 | 2007-01-08 |
| 1558457143 | Han N Lee | Dermatology | 435 W Arden Ave, #435, Glendale, CA 91203-4044 | 2006-10-04 |
| 1811095342 | Carmen S Balding | Dermatology | 375 W. River Woods Prkwy, Glendale, WI 53212 | 2006-09-20 |
| 1356454557 | Donny Mehrabi | Dermatology | 1505 Wilson Ter Ste 240, Glendale, CA 91206-4033 | 2006-08-15 |
| 1821047283 | James Edward Berman | Dermatology | 7040 N Port Washington Rd, Suite 404, Glendale, WI 53217-3885 | 2006-05-10 |
| 1275506081 | Thorsteinn Skulason | Dermatology | 375 W River Woods Pkwy, Suite 116, Glendale, WI 53212-1080 | 2006-02-10 |
| 1104810720 | James Frederick Pehoushek | Dermatology | 6320-a W Union Hills Dr., Ste 100, Glendale, AZ 85308-1051 | 2005-09-09 |
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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.