NPIMap

Organization Active NPI

Radiant Complexions Dermatology Clinics

  • Clinic/Center
  • Surprise, AZ
National Provider Identifier
1295989077
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
RN114597 Issued in AZ
Legal business name
RADIANT COMPLEXIONS DERMATOLOGY CLINICS
Practice address
16952 W Bell Rd Ste 304
Surprise, AZ 85374-8951
Phone
(623) 584-3588
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

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

Authorized official

Name
Dr. Charles Love, M.D.NPI 1043312432
Title
Medical Director
Phone
(515) 226-8484

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
Clinic/Center 261Q00000X RN114597 AZ Primary

Addresses

Primary practice location

16952 W Bell Rd Ste 304
Surprise, AZ 85374-8951

Mailing address

16952 W Bell Rd Ste 304
Surprise, AZ 85374-8951
Phone (623) 584-3588

Other names 1

  • RCDC Surprise Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225929600000",
    "number": "1295989077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16952 W BELL RD STE 304",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748951",
            "telephone_number": "623-584-3588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16952 W BELL RD STE 304",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748951",
            "telephone_number": "623-584-3588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT COMPLEXIONS DERMATOLOGY CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "515-226-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "RN114597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RCDC Surprise",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; 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.