Skin Concierge, LLC.

Primary specialty

Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X

Legal business name

SKIN CONCIERGE, LLC.

Practice address

1310 W. St. Mary'S Road
2ND Floor, Suite a
Tucson, AZ 85745

Phone

(520) 333-5973

Fax

(520) 221-2318

NPI assigned

Aug 9, 2017

Organization subpart

No

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

Authorized official

Name

Destiny Gypsylee Mattox

Title

Practice Manager

Phone

(520) 333-5973

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• David A Gutzmann, D.D.S.

  • Dentist
  • Tucson, AZ
  • NPI 1508847393
  NPD (past)
• Valentino James Pugnea, D.D.S.

  • General Practice Dentistry
  • Tucson, AZ
  • NPI 1205958568
  NPD (past)

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1497270664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W SAINT MARYS RD STE A",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857453231",
            "telephone_number": "520-333-5973",
            "fax_number": "520-221-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W. ST. MARY'S ROAD",
            "address_2": "2ND FLOOR, SUITE A",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85745",
            "telephone_number": "520-333-5973",
            "fax_number": "520-221-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CONCIERGE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-09",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "MATTOX",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_middle_name": "GYPSYLEE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "520-333-5973"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162831",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ski Ambulatory Surgical Centers, LLC
• Stephen Skiano, PA-C
• Alexandria Skidmore, PT, DPT
• Jean A Skiles
• Ashlee Skillings, MD
• Linda Joan Skinker, RPH
• David Peterson Skinner Jr., MD, PHD, MBA
• Jessica F Skinner
• Kristina Therese Skinner, M.A.-SLP, CF
• Savanna Skinner, FNP-C

• Dermatology Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.