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

Randall J Blazic, DDSMD

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1497843445

Randall J Blazic, DDSMD is an Oral & Maxillofacial Surgery (D.M.D.) in Goodyear, Arizona. Licensed in Arizona. Registered with an NPI since 2006.

Licensed in
AZ
In the registry since
2006
Specialties on file
2

Practice location Address checks out

13980 W Avalon Dr Ste 120
Goodyear, AZ 85395-1404
Phone: (623) 935-5774
Fax: (623) 935-6524
Show map & directions

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

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence D5976 (AZ)
Oral & Maxillofacial Surgery (D.M.D.) Taxonomy 204E00000X · Licence M31657 (AZ)

Record details

NPI number1497843445
Entity typeIndividual (Type 1)
GenderMale
Credentials DDSMD
Sole proprietorNo
NPI enumeratedOctober 11, 2006
Last updated in NPPESApril 22, 2025
Certification dateApril 22, 2025
Mailing address13980 W Avalon Dr Ste 120, Goodyear, AZ 85395-1404

Other providers in Goodyear