Healthcare Provider Details

I. General information

NPI: 1881694917
Provider Name (Legal Business Name): DEAN F. WEINBERG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 03/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16222 N 59TH AVE SUITE A-100
GLENDALE AZ
85306-1701
US

IV. Provider business mailing address

16222 N 59TH AVE SUITE A-100
GLENDALE AZ
85306-1701
US

V. Phone/Fax

Practice location:
  • Phone: 623-334-4000
  • Fax: 623-334-4400
Mailing address:
  • Phone: 623-334-4000
  • Fax: 623-334-4400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8357
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: