Healthcare Provider Details

I. General information

NPI: 1336028588
Provider Name (Legal Business Name): DEKKER MEDICAL INDUSTRIAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8686 E SAN ALBERTO STE 100
SCOTTSDALE AZ
85258-4380
US

IV. Provider business mailing address

8686 E SAN ALBERTO STE 100
SCOTTSDALE AZ
85258-4380
US

V. Phone/Fax

Practice location:
  • Phone: 480-561-0141
  • Fax: 602-429-8447
Mailing address:
  • Phone: 480-561-0141
  • Fax: 602-429-8447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ALLEN DEKKER
Title or Position: OWNER
Credential: DO
Phone: 954-319-8579