Healthcare Provider Details

I. General information

NPI: 1053247817
Provider Name (Legal Business Name): JONATHAN DAVID CRAIG-MENDES JD, MBA, HEC-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 W THUNDERBIRD RD
GLENDALE AZ
85306-4622
US

IV. Provider business mailing address

3905 N. 7TH AVE. UNIT 33232
PHOENIX AZ
85067
US

V. Phone/Fax

Practice location:
  • Phone: 480-543-2331
  • Fax:
Mailing address:
  • Phone: 623-715-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174V00000X
TaxonomyClinical Ethicist
License Number00132828
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: