Westside Ear Nose & Throat PC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

17587 Issued in AZ

Legal business name

WESTSIDE EAR NOSE & THROAT PC

Practice address

5757 W Thunderbird Rd
Suite W301
Glendale, AZ 85306-4641

Phone

(602) 938-3777

Fax

(602) 547-0379

NPI assigned

Dec 7, 2005

Organization subpart

No

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

Authorized official

Name

Sudhir P Agarwal, MD

Title

President/Owner

Phone

(602) 938-3777

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

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

• Ravi P Agarwal, MD

  • Otolaryngology Physician
  • Glendale, AZ
  • NPI 1588647424
  Medicare reassignment NPD

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1376528976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE W301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-938-3777",
            "fax_number": "602-547-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD",
            "address_2": "SUITE W301",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064641",
            "telephone_number": "602-938-3777",
            "fax_number": "602-547-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE EAR NOSE & THROAT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-07",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "SUDHIR",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "602-938-3777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "17587",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "28376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Westside Surgery Center of Arizona, LLC
• Westwind Dental Glendale, PLLC
• Westwind Dental Thunderbird

• Otolaryngology Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Otolaryngology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.