East Valley Pediatric Plastic Surgery, PLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

EAST VALLEY PEDIATRIC PLASTIC SURGERY, PLC

Practice address

1432 S Dobson Rd Ste 401
Mesa, AZ 85202-4777

Phone

(480) 658-0123

Fax

(480) 383-6429

NPI assigned

Nov 12, 2018

Organization subpart

No

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

Authorized official

Name

David Workman

Title

Business Manager

Phone

(480) 658-0123

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1205304995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W CARLA VISTA DR # 6367",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852248201",
            "telephone_number": "614-556-0875",
            "fax_number": "480-383-6429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD STE 401",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024777",
            "telephone_number": "480-658-0123",
            "fax_number": "480-383-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY PEDIATRIC PLASTIC SURGERY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "480-658-0123"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Valley Ophthalmology, LTD
• East Valley Orthodontics
• East Valley Outpatient Surgery, LLC
• East Valley Pain Relief, LLC
• East Valley Patient Care Services
• East Valley Periodontics
• East Valley Phoenix ASC LLC
• East Valley Physical Therapy & Aquatic Rehabilitation LTD
• East Valley Physicians Group (Red Mountain Chiro-Med)
• East Valley Physicians Group PLLC (Red Mountain Family Chiro-Med)

• Plastic Surgery Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; 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.