Organization Active NPI

Saguaro Dermatology Associates LLC

  • Dermatology Physician
  • Phoenix, AZ
National Provider Identifier
1114485646
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SAGUARO DERMATOLOGY ASSOCIATES LLC
Practice address
3400 E McDowell Rd FL 2
Phoenix, AZ 85008-3884
Phone
(480) 681-3300
Fax
(480) 681-3301
NPI assigned
Mar 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
Dathan Hamann, MDNPI 1760801070
Title
Owner
Phone
(480) 681-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3400 E McDowell Rd FL 2
Phoenix, AZ 85008-3884

Mailing address

PO Box 61025
Phoenix, AZ 85082-1025
Phone (480) 681-3000

Other practice location 1

4530 E Shea Blvd Ste 101
Phoenix, AZ 85028-6066
Phone (602) 867-7546

Other practice location 2

2150 S Dobson Rd Ste 1
Mesa, AZ 85202-6487
Phone (480) 820-9774

Other practice location 3

4425 E Agave Rd Ste 148
Phoenix, AZ 85044-0623
Phone (480) 771-0279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190917003012 AZ Part B Supplier - Clinic/Group Practice 3577892561 Receives reassigned benefits from 14 practitioners
Practice locations: Mesa, AZ; Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2162146Saguaro Dermatology Associates, LLC3400 E McDowell Road, Phoenix, AZ 85008ComplianceMay 13, 2028

National Provider Directory

National Provider Directory

Locations

120 W Highway 287
Florence, AZ 85132
Phone (954) 275-7026

2150 S Dobson Rd
Mesa, AZ 85202

3400 E McDowell Rd
Fl 2
Phoenix, AZ 85008
Phone (480) 681-3300

4425 E Agave Rd
Phoenix, AZ 85044
Phone (480) 274-4860

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1114485646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61025",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850821025",
            "telephone_number": "480-681-3000",
            "fax_number": "480-681-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E MCDOWELL RD FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850083884",
            "telephone_number": "480-681-3300",
            "fax_number": "480-681-3301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4530 E Shea Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850286066",
            "country_code": "US",
            "telephone_number": "602-867-7546",
            "fax_number": "608-971-0065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 S Dobson Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852026487",
            "country_code": "US",
            "telephone_number": "480-820-9774",
            "fax_number": "480-897-0820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4425 E Agave Rd Ste 148",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850440623",
            "country_code": "US",
            "telephone_number": "480-771-0279",
            "fax_number": "480-704-7549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAGUARO DERMATOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "HAMANN",
        "authorized_official_first_name": "DATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-681-3300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.