NPIMap

Organization Active NPI

Dziduch Medical, PLLC

  • Primary Care Clinic/Center
  • Chandler, AZ
National Provider Identifier
1639710726
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
DZIDUCH MEDICAL, PLLC
Practice address
2680 E Germann Rd
Chandler, AZ 85286-1423
Phone
(480) 712-9100
Fax
(480) 597-1701
NPI assigned
Oct 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Jessie Dziduch, FNP-CNPI 1265900591
Title
Owner
Phone
(480) 286-0538

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2680 E Germann Rd
Chandler, AZ 85286-1423

Mailing address

2680 E Germann Rd
Chandler, AZ 85286-1423
Phone (480) 286-0538

National Provider Directory

National Provider Directory

Locations

2680 E Germann Rd
Chandler, AZ 85286
Phone (480) 712-9100

Practitioners & affiliated clinicians

Practitioners 1

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": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1639710726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 E GERMANN RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861423",
            "telephone_number": "480-286-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 E GERMANN RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861423",
            "telephone_number": "480-712-9100",
            "fax_number": "480-597-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DZIDUCH MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "DZIDUCH",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-286-0538",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.