Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Actinodermatology Ltd

Organization Dermatology Physician · NPI 1063695252

Actinodermatology Ltd provides Dermatology Physician services in Tempe, Arizona. Licensed in Arizona. Registered with an NPI since 2007.

Licensed in
AZ
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2600 E Southern Ave #A-2
Tempe, AZ 85282-7610 Not confirmed with CMS for 16 years — call before visiting
Phone: (480) 839-1767
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 7979 (AZ)

Record details

NPI number1063695252
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerry Ponitch — President · (480) 839-1767
NPI enumeratedDecember 11, 2007
Last updated in NPPESApril 1, 2010
Mailing address2600 E Southern Ave, A-2, Tempe, AZ 85282-7610

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