Dermal Wellness Group LLC

Primary specialty

Other Specialist/TechnologistTaxonomy code 246Z00000X

Legal business name

DERMAL WELLNESS GROUP LLC

Practice address

4425 E Agave Rd Ste 106
Phoenix, AZ 85044-0620

Phone

(407) 982-4876

Fax

(407) 650-2754

NPI assigned

Aug 6, 2025

Last updated

Aug 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fariba NowtashNPI 1487539706

Title

Owner

Phone

(602) 318-7273

Specialties & licenses 1

Addresses

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.

• Fariba Nowtash

  • Other Specialist/Technologist
  • Phoenix, AZ
  • NPI 1487539706
  Authorized official Same address or phone

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

{
    "created_epoch": "1754438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1881579100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 E AGAVE RD STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850440620",
            "telephone_number": "407-982-4876",
            "fax_number": "407-650-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 E AGAVE RD STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850440620",
            "telephone_number": "407-982-4876",
            "fax_number": "407-650-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMAL WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "NOWTASH",
        "authorized_official_first_name": "FARIBA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-318-7273"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott R Derenne, PA-C (PHYSICIAN ASSI
• Silvia Dergal
• Regina Jane Deringer, FNP
• Emily Rae Derks, OTR/L
• Brenna J. Derksen, MD
• Dermatology Associates, P.C.
• Dermatology Clinic LTD
• Dermatology Vein and Laser Institute LLC
• Darrell James Dern, M.S., CCC-SLP
• Brad Deroma

• Other Specialist/Technologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Other Specialist/Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.