Healthcare Provider Details

I. General information

NPI: 1932964806
Provider Name (Legal Business Name): JILLIAN ELIZABETH BASSETT AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14510 W SHUMWAY DR STE 101
SUN CITY WEST AZ
85375-5815
US

IV. Provider business mailing address

7949 N VIA AZUL
SCOTTSDALE AZ
85258-2825
US

V. Phone/Fax

Practice location:
  • Phone: 623-975-1660
  • Fax: 623-584-4282
Mailing address:
  • Phone: 623-975-1660
  • Fax: 623-584-4282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAD17104
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: