Crystal Optical PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1717 Issued in AZ

Legal business name

CRYSTAL OPTICAL PLLC

Practice address

401 E Bell Rd Ste 24
Phoenix, AZ 85022

Phone

(602) 375-1041

NPI assigned

Dec 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Dina Hamideh, ODNPI 1235268061

Title

Managing Employee

Phone

(602) 375-1041

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

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

• Dina A Hamideh, O.D

  • Optometrist
  • Phoenix, AZ
  • NPI 1235268061
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1295241610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E BELL RD STE 24",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850222395",
            "telephone_number": "602-375-1041",
            "fax_number": "602-375-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E BELL RD STE 24",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85022",
            "telephone_number": "602-375-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL OPTICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "HAMIDEH",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "602-375-1041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Emily Cruz
• Tania Cruz, SLPA
• Vernice Cruz, AGNP
• Marilyn C Cryan, RD
• Crystal Home Care Az LLC
• Ana Csanyi
• Cthvamc
• Daisy Marilu Cuadra
• Elka Mushka Cubacub, MSW
• Regine Cubbage

• Optometrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.