Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Omni Dermatology Incorporated

Organization Dermatology Physician · NPI 1003082090

Omni Dermatology Incorporated is a Dermatology Physician in Glendale, Arizona. Licensed in Arizona. Registered with an NPI since 2008.

Licensed in
AZ
In the registry since
2008

Practice location Address checks out

11851 N 51st Ave Ste E130
Glendale, AZ 85304-2843
Phone: (480) 954-3919
Fax: (480) 954-3670
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 4311 (AZ)

Record details

NPI number1003082090
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Racette — President · (602) 369-3634
NPI enumeratedApril 30, 2008
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024
Mailing address11851 N 51st Ave Ste E130, Glendale, AZ 85304-2843

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