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General NPI Number Information
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NPI Number | 1114183209
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Entity Type | Organization
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Legal Business Name | BRIAN D DEDINSKY MD PC
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Dates
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Enumeration Date | 07/29/2008
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 367 E VIRGINIA AVE
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City | PHOENIX
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State | AZ
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Zip | 85004-1202
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Country | US
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Telephone | 602-256-6303
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Fax | 602-256-6302
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Provider Business Mailing Address
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Address Line | 367 E VIRGINIA AVE
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City | PHOENIX
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State | AZ
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Zip | 85004-1202
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Country | US
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Telephone | 602-256-6303
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Fax | 602-256-6302
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN DAVID DEDINSKY
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Credential | M.D.
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Telephone | 602-256-6303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AZ20400
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | AZ20400
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License Number State | AZ
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