Healthcare Provider Details

I. General information

NPI: 1265202048
Provider Name (Legal Business Name): KIDFINITY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20221 N 67TH AVE STE E3
GLENDALE AZ
85308-0602
US

IV. Provider business mailing address

11022 N 28TH DR STE 100
PHOENIX AZ
85029-5634
US

V. Phone/Fax

Practice location:
  • Phone: 623-462-1981
  • Fax: 623-400-3348
Mailing address:
  • Phone: 623-462-1981
  • Fax: 623-400-3348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DEVIKA MALHOTRA
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 480-329-8796