NPIMap

Organization Active NPI

Banner Pediatric Specialists LLC

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
National Provider Identifier
1639323447
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BANNER PEDIATRIC SPECIALISTS LLC
Practice address
1432 S Dobson Rd
Mesa, AZ 85202-4768
Phone
(480) 614-3665
NPI assigned
Nov 6, 2008
Organization subpart
Yes
Parent organization
BANNER HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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

Authorized official

Name
Dennis Dahlen
Title
Sr VP Finance
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1432 S Dobson Rd
Mesa, AZ 85202-4768

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

National Provider Directory

National Provider Directory
Part of
M E Lee MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1432 S Dobson Rd
Ste 107
Mesa, AZ 85202
Phone (480) 412-4100

9755 N 90th St
Ste C220
Scottsdale, AZ 85258

9755 N 90th St
Ste 200
Scottsdale, AZ 85258

Practitioners & affiliated clinicians

Practitioners 4

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": "1239926400000",
    "number": "1639323447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1432 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024768",
            "telephone_number": "480-614-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PEDIATRIC SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2008-11-06",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.