Healthcare Provider Details

I. General information

NPI: 1720248826
Provider Name (Legal Business Name): REZA ARYAI ROD MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14551 W INDIAN SCHOOL RD STE 240
GOODYEAR AZ
85395-9283
US

IV. Provider business mailing address

14551 W INDIAN SCHOOL RD STE 240
GOODYEAR AZ
85395-9283
US

V. Phone/Fax

Practice location:
  • Phone: 623-535-7050
  • Fax: 623-535-7068
Mailing address:
  • Phone: 623-535-7050
  • Fax: 623-535-7068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number38069
License Number StateAZ

VIII. Authorized Official

Name: REZA ARYAI ROD
Title or Position: MANAGING EMPLOYEE
Credential: MD
Phone: 608-217-6567