NPIMap

Organization Active NPI

East Valley Dermatology RX, LLC

  • Non-Pharmacy Dispensing Site
  • Chandler, AZ
National Provider Identifier
1013312925
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
EAST VALLEY DERMATOLOGY RX, LLC
Practice address
1100 S Dobson Rd
#223
Chandler, AZ 85286-6157
Phone
(480) 821-8888
Fax
(480) 821-0888
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer Ann Davis
Title
Office Manager
Phone
(480) 821-8888

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 26816 AZ
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

1100 S Dobson Rd
#223
Chandler, AZ 85286-6157

Mailing address

1100 S Dobson Rd
#223
Chandler, AZ 85286-6157
Phone (480) 821-8888

National Provider Directory

National Provider Directory

Locations

1100 S Dobson Rd
Ste 223
Chandler, AZ 85286
Phone (480) 821-8888

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572307200000",
    "number": "1013312925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "#223",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-821-8888",
            "fax_number": "480-821-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S DOBSON RD",
            "address_2": "#223",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866157",
            "telephone_number": "480-821-8888",
            "fax_number": "480-821-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY DERMATOLOGY RX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2019-10-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-821-8888"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "26816",
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.