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CRYSTAL CANYON ENT & FACIAL PLASTIC SURGERY PC
NPI 1285780767
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Flagstaff, AZ

Active since January 26, 2007
1340 N RIM DR, FLAGSTAFF, AZ 86001(928) 774-1873(928) 774-5525 Get Directions Write a Review

NPPES record last updated: April 4, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Crystal Canyon Ent & Facial Plastic Surgery Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CRYSTAL CANYON ENT & FACIAL PLASTIC SURGERY PC (NPI 1285780767) is a healthcare organization registered as an otolaryngology/facial plastic surgery in Flagstaff, Arizona and active in the NPI registry since January 2007. The organization lists Pamela A Taylor, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1285780767
Entity TypeOrganization
Primary Taxonomy207YX0905X
Legal Business NameCRYSTAL CANYON ENT & FACIAL PLASTIC SURGERY PC
Location Address1340 N RIM DRFlagstaff, AZ 86001-3111
Mailing Address1340 N Rim DrFlagstaff, AZ 86001-3111 · (928) 774-1873 · Fax (928) 774-5525
Phone(928) 774-1873
Fax(928) 774-5525
Organization SubpartNo
Authorized OfficialPamela A TaylorOffice Manager · (928) 774-1873
Enumeration DateJanuary 26, 2007
Last NPPES UpdateApril 4, 2013
✔ NPI 1285780767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
License✔ Licensed in AZ · MD3000
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Also ListedAllergy & ImmunologyTaxonomy 207K00000X · License MD3000 (AZ)
1340 N RIM DR, Flagstaff, AZ 86001
Open in Google Maps ↗

Other Identifiers 5

OtherAZ0228870AZ · Bcbsaz
Medicare ID-Type UnspecifiedZ29951AZ
Other1000074AZ · United Health Care
Medicare UPING07076AZ
Medicaid316762AZ

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAMARAH FRATIANNI D.O
Otolaryngology (Facial Plastic Surgery)
1340 N RIM DR
FLAGSTAFF, AZ 86001
Coconino County (928) 774-1873

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Crystal Canyon Ent & Facial Plastic Surgery PC's NPI number?

The NPI number for Crystal Canyon Ent & Facial Plastic Surgery PC is 1285780767. It was assigned to this organization in the NPPES registry on January 26, 2007.

Where is Crystal Canyon Ent & Facial Plastic Surgery PC located?

Crystal Canyon Ent & Facial Plastic Surgery PC is located at 1340 N Rim Dr, Flagstaff, AZ 86001. The listed phone number is (928) 774-1873.

What is Crystal Canyon Ent & Facial Plastic Surgery PC's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

When was this NPI record last updated?

The NPPES record for Crystal Canyon Ent & Facial Plastic Surgery PC was last updated on April 4, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.