NPIMap

Organization Active NPI

Arizona Craniofacial & Plastic Surgery Center PC

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1891905006
Registry record updated Jun 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
23958 Issued in AZ
Legal business name
ARIZONA CRANIOFACIAL & PLASTIC SURGERY CENTER PC
Practice address
15721 N Greenway Hayden Loop
#201
Scottsdale, AZ 85260-1650
Phone
(480) 905-9211
Fax
(480) 905-0504
NPI assigned
May 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2008

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

Authorized official

Name
Amber Alene Wallis
Title
Office Manager
Phone
(480) 905-9211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 23958 AZ Primary

Addresses

Primary practice location

15721 N Greenway Hayden Loop
#201
Scottsdale, AZ 85260-1650

Mailing address

15721 N Greenway Hayden Loop
#201
Scottsdale, AZ 85260-1650
Phone (480) 905-9211

National Provider Directory

National Provider Directory

Locations

15721 N Greenway Hayden Loop
Ste 201
Scottsdale, AZ 85260
Phone (480) 905-9211

15721 N Greenway Hayden Loop
Scottsdale, AZ 85260
Phone (480) 905-9211

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214092800000",
    "number": "1891905006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15721 N GREENWAY HAYDEN LOOP",
            "address_2": "#201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601650",
            "telephone_number": "480-905-9211",
            "fax_number": "480-905-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15721 N GREENWAY HAYDEN LOOP",
            "address_2": "#201",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601650",
            "telephone_number": "480-905-9211",
            "fax_number": "480-905-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA CRANIOFACIAL & PLASTIC SURGERY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-06-22",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "ALENE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-905-9211"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "AZ",
            "license": "23958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2008; 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.