Healthcare Provider Details

I. General information

NPI: 1851077564
Provider Name (Legal Business Name): DANA LOESCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 N 40TH ST STE 204
PHOENIX AZ
85032-3356
US

IV. Provider business mailing address

4022 E GREENWAY RD STE 11-195
PHOENIX AZ
85032-4797
US

V. Phone/Fax

Practice location:
  • Phone: 480-591-9544
  • Fax: 602-953-5466
Mailing address:
  • Phone: 480-591-9544
  • Fax: 602-953-5466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: