Healthcare Provider Details

I. General information

NPI: 1093409849
Provider Name (Legal Business Name): DESIREE CELESTE MAJOR DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18301 N 79TH AVE STE 168
GLENDALE AZ
85308-6045
US

IV. Provider business mailing address

18301 N 79TH AVE STE 168
GLENDALE AZ
85308-6045
US

V. Phone/Fax

Practice location:
  • Phone: 602-892-6335
  • Fax:
Mailing address:
  • Phone: 602-892-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD-001162
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: