SKIN DEEP AESTHETICS, LLC (NPI# 1871051383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871051383 |
| Entity Type | Organization |
| Organization Name | SKIN DEEP AESTHETICS, LLC |
| Other Organization Name | SKIN DEEP DERMATOLOGY & AESTHETICS |
| Practice Address |
1714 W Guadalupe Rd Ste 201 Gilbert AZ 85233-2943 |
| Practice Telephone | 4809801968 |
| Mailing Telephone | 4809801968 |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-06 |
| Authorized Official Name | MARY FRAUSTO (OWNER/ PROVIDER) |
| Authorized Official Telephone | 4809801968 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Skin Deep Dermatology & Aesthetics | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entity | Skin Deep Aesthetics, LLC | 117 BETHEL PARK DR , LYNCHBURG, VA 24502 |
| Colorado Business Entity | Skin Deep Aesthetics, LLC | 9791 West Unser Avenue , Littleton, CO 80128 |
| Street Address |
1714 W GUADALUPE RD STE 201 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85233-2943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467063594 | Specialized Education of Arizona, Inc. | Day Training, Developmentally Disabled Services | 875 S. Coooper Rd., Gilbert, AZ 85233 | 2020-08-12 |
| 1336649425 | Jason Diminico | Behavior Technician | 82 W Gilbert Road, Gilbert, AZ 85233 | 2018-02-15 |
| 1508378274 | L & S Az L.L.C. | Family Medicine | 201 W. Guadalupe Rd #102, Gilbert, AZ 85233 | 2017-11-02 |
| 1740799022 | Angel Day Care LLC | Clinic/Center | 815 W Wagner Ct, Gilbert, AZ 85233 | 2017-09-29 |
| 1235656356 | Jason Karstens | Physical Therapist | 1447 West Elliot Road, Suite 101, Gilbert, AZ 85233 | 2017-08-29 |
| 1538684956 | Independent By Design, Pllc | Occupational Therapy Assistant | 835 W Warner Rd Suite 101 - 623, Gilbert, AZ 85233 | 2017-08-07 |
| 1619406998 | Marri Keller | Physical Therapist | 690 Copper Rd, Suite 101, Gilbert, AZ 85233 | 2017-06-08 |
| 1538692470 | Ocotillo Medical Group LLC | Chiropractor | 2815 E. Ocotillo Rd, #4, Chandler, AZ 85233 | 2017-04-07 |
| 1922544634 | Riann Naomi Simmons | Nurse Practitioner | 800 W Elliot Road, Suite 103, Gilbert, AZ 85233 | 2017-01-19 |
| 1154793685 | Laura Beth Masters | Nurse Practitioner | Shelley Staymates, 890 W Elliott #120, Gilbert, AZ 85233 | 2015-10-23 |
| Find all providers in zip 85233 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982819397 | Tamra Whiteley-myers Md PC | Dermatology | 5190 E Farness Dr Ste 110, Tucson, AZ 85712-2142 | 2007-05-11 |
| 1871653840 | Cynthia Jean Modny | Dermatology | 2402 E San Miguel Ave, Phoenix, AZ 85016-2815 | 2006-12-11 |
| 1518928878 | Mark A Meyers | Dermatology | 715 S Beeline Hwy, Ste A, Payson, AZ 85541-5344 | 2006-03-28 |
| 1235128851 | Andrew S. Tedesco | Dermatology | 6648 E Carondelet Dr, Tucson, AZ 85710-2119 | 2005-10-17 |
| 1861498297 | Keith Andrew Mackenzie | Dermatology | 3190 Clearwater Dr, Prescott, AZ 86305-7131 | 2005-06-21 |
| 1083066450 | Arizona Skin and Laser Therapy Institue, Ltd | Dermatology | 16620 N 40th St, Suite C-3, Phoenix, AZ 85032-3348 | 2016-07-08 |
| 1548634348 | La Peau Dermatology LLC | Dermatology | 5424 E Southern Ave, Suite 103, Mesa, AZ 85206-3621 | 2015-11-17 |
| 1972861326 | Ryan Mark Proctor | Dermatology | 3015 Hway 95, Suite 110, Bullhead City, AZ 86442-4334 | 2012-04-23 |
| 1427340389 | Brenda Latowsky M.d. P.l.c. | Dermatology | 12251 N 32nd St, Phoenix, AZ 85032-7189 | 2011-05-11 |
| 1003112327 | Northern Arizona Dermatology Center, PC | Dermatology | 501 N Navajo, Page, AZ 86040 | 2011-02-03 |
| Find all providers with the same taxonomy | ||||
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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.