1073515037 NPI number — DCX ENTERPRISES, P.C.

Table of content: (NPI 1073515037)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073515037 NPI number — DCX ENTERPRISES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DCX ENTERPRISES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073515037
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7908 E CHAPARRAL RD
Provider Second Line Business Mailing Address:
STE B109
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85250-7215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-994-8900
Provider Business Mailing Address Fax Number:
480-994-4665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7908 E CHAPARRAL RD
Provider Second Line Business Practice Location Address:
STE B109
Provider Business Practice Location Address City Name:
SCOTTSDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85250-7215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-994-8900
Provider Business Practice Location Address Fax Number:
480-994-4665
Provider Enumeration Date:
06/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CHISM
Authorized Official First Name:
CHRISTI
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-994-8900

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5360 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AZ0240430 . This is a "BLUE CROSS" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 1Z4251 . This is a "HEALTH NET" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 623741 . This is a "ACN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: P1639379 . This is a "FIRST HEALTH" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 350037314 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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