| Brian D Dedinsky MD PC | |
|
367 E Virginia Ave Phoenix AZ 85004-1202 | |
| (602) 256-6303 | |
| (602) 256-6302 |
| Full Name | Brian D Dedinsky MD PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 367 E Virginia Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Brian David Dedinsky (OWNER) |
| Authorized Official Contact | 6022566303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian D Dedinsky MD PC 367 E Virginia Ave Phoenix AZ 85004-1202 Ph: (602) 256-6303 | Brian D Dedinsky MD PC 367 E Virginia Ave Phoenix AZ 85004-1202 Ph: (602) 256-6303 |
| NPI Number | 1114183209 |
|---|---|
| Provider Enumeration Date | 07/29/2008 |
| Last Update Date | 02/12/2026 |
| Certification Date | 02/12/2026 |
| Medicare PECOS PAC ID | 2466528450 |
|---|---|
| Medicare Enrollment ID | O20080827000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114183209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | AZ20400 (Arizona) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | AZ20400 (Arizona) | Primary |
| Provider Name | Brian D Dedinsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730238106 PECOS PAC ID: 0941235980 Enrollment ID: I20050928001293 |
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