Organization Active NPI

Trinity ENT and Facial Aesthetics, LLC

  • Facial Plastic Surgery Physician
  • Gilbert, AZ
National Provider Identifier
1649400847
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
34172 Issued in AZ
Legal business name
TRINITY ENT AND FACIAL AESTHETICS, LLC
Practice address
3485 S Mercy Rd
Suite 103
Gilbert, AZ 85297-0429
Phone
(480) 558-3223
Fax
(480) 558-5152
NPI assigned
Jul 22, 2009
Last updated
Jul 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Dr. Veena V Vats, MDNPI 1760472567
Title
Ownerphysician
Phone
(480) 558-3223

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 34172 AZ Primary

Addresses

Primary practice location

3485 S Mercy Rd
Suite 103
Gilbert, AZ 85297-0429

Mailing address

3485 S Mercy Rd
Suite 103
Gilbert, AZ 85297-0429
Phone (480) 558-3223

Other identifiers 1

IdentifierTypeStateIssuer
212627MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091117000698 AZ Part B Supplier - Clinic/Group Practice 1052459716 Receives reassigned benefits from 2 practitioners
Practice locations: Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

3485 S Mercy Rd
Ste 103
Gilbert, AZ 85297
Phone (480) 558-3223

3485 S Mercy Rd
Ste 104
Gilbert, AZ 85297
Phone (480) 558-3223

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1649400847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-558-3223",
            "fax_number": "480-558-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 S MERCY RD",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970429",
            "telephone_number": "480-558-3223",
            "fax_number": "480-558-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY ENT AND FACIAL AESTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "VATS",
        "authorized_official_first_name": "VEENA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNERPHYSICIAN",
        "authorized_official_telephone_number": "480-558-3223",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "34172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212627",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.