Valley Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

VALLEY DERMATOLOGY PLLC

Practice address

5702 W Glendale Ave
Glendale, AZ 85301-2556

Phone

(623) 937-8969

NPI assigned

Feb 26, 2025

Last updated

Mar 3, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kyle Sanniec, MDNPI 1912340043

Title

Manager

Phone

(602) 376-8638

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diana Alexis Jimenez, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1215509336
  Medicare reassignment Care Compare group NPD
• Kyle Sanniec, MD

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1912340043
  Medicare reassignment NPD Authorized official
• Michelle Nemeh

  • Physician Assistant
  • Glendale, AZ
  • NPI 1417413337
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1578360665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94765",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850704765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 W GLENDALE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853012556",
            "telephone_number": "623-937-8969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 S Gilbert Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852045235",
            "country_code": "US",
            "telephone_number": "480-779-4008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VALLEY DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "SANNIEC",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-376-8638",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daira Valenzuela, RBT
• Diana Noemi Valenzuela
• Jessica Valladolid, MSN, APRN, FNP-C
• Valley Allergy and Asthma Clinic PLLC
• Valley Chest & Vascular Surgeons PLLC
• Valley Gastrointestinal Care
• Valley Hospitalists, LLC
• Valley Injury Specialists LLC
• Valley Life Solutions LLC
• Valley of the Sun Dentistry P.L.L.C.

• Dermatology Physician in Glendale, AZ
• Providers in Glendale, 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 3, 2025; 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.