Organization Active NPI

Desert Oasis Dermatology PLLC

  • Dermatology Physician
  • Maricopa, AZ
National Provider Identifier
1780489526
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DESERT OASIS DERMATOLOGY PLLC
Practice address
21300 N John Wayne Pkwy Ste 108
Maricopa, AZ 85139-8964
Phone
(480) 418-3314
Fax
(480) 923-6586
NPI assigned
Feb 17, 2025
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Dr. Jonathan Lavian, MDNPI 1801327309
Title
Dermatologist
Phone
(480) 418-3314

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
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

21300 N John Wayne Pkwy Ste 108
Maricopa, AZ 85139-8964

Mailing address

13835 N Tatum Blvd Ste 9-268
Phoenix, AZ 85032-5590
Phone (480) 418-3314

Other practice location 1

2860 S Alma School Rd Ste 33
Chandler, AZ 85286-4395
Phone (480) 418-3314

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250321003411 AZ Part B Supplier - Clinic/Group Practice 5294257960 Receives reassigned benefits from 1 practitioner
Practice locations: Maricopa, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2325854Desert Oasis Dermatology-Maricopa21300 N John Wayne Pkwy Ste 108, Maricopa, AZ 85139RegistrationApr 30, 2028
03D2339060Desert Oasis Dermatology-Chandler2860 S Alma School Rd Ste 33, Chandler, AZ 85286RegistrationFeb 22, 2028

National Provider Directory

National Provider Directory

Locations

21300 N John Wayne Pkwy
Ste 108
Maricopa, AZ 85139
Phone (480) 418-3314

13835 N Tatum Blvd
Ste 9268
Phoenix, AZ 85032

Practitioners & affiliated clinicians

Practitioners 1

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": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1780489526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13835 N TATUM BLVD STE 9-268",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325590",
            "telephone_number": "480-418-3314",
            "fax_number": "480-923-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21300 N JOHN WAYNE PKWY STE 108",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851398964",
            "telephone_number": "480-418-3314",
            "fax_number": "480-923-6586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2860 S Alma School Rd Ste 33",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852864395",
            "country_code": "US",
            "telephone_number": "480-418-3314",
            "fax_number": "480-923-6586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DESERT OASIS DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "LAVIAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "480-418-3314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maricopa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.