Desert Valley Plastic Surgery PLLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

DESERT VALLEY PLASTIC SURGERY PLLC

Practice address

18325 N Allied Way Ste 120
Phoenix, AZ 85054-3107

Phone

(480) 770-5015

Fax

(480) 691-2450

NPI assigned

Sep 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Genaro Francisco Valladolid, MDNPI 1861788192

Title

Member Manager

Phone

(480) 770-5015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Tax ID family

Desert Valley Plastic Surgery PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Desert Valley Plastic Surgery PLLC

  • Plastic Surgery Physician
  • Mesa, AZ
  • NPI 1225893696
  NPD tax ID

Locations

Practitioners 1

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

• Genaro Francisco Valladolid, M.D.

  • Plastic Surgery Physician
  • Indianapolis, IN
  • NPI 1861788192

  AZ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1629682190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 N 90TH ST STE 102",
            "address_2": "PMB 291",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585073",
            "telephone_number": "480-770-5015",
            "fax_number": "480-691-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 N ALLIED WAY STE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850543107",
            "telephone_number": "480-770-5015",
            "fax_number": "480-691-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VALLEY PLASTIC SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "VALLADOLID",
        "authorized_official_first_name": "GENARO",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "480-770-5015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Valley Hospice LLC
• Desert Valley Hospice LLC
• Desert Valley Infectious Disease Physicians
• Desert Valley Pediatric Therapy
• Desert Valley Pediatrics
• Desert Valley Primary Care Physicians
• Desert Valley Radiology, PLC
• Desert Valley Radiology, PLC
• Desert Valley Radiology, PLC
• Desert View Assisted Living

• Plastic Surgery Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.