Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

WILLOW DERMATOLOGY, PLLC
NPI 1558216093
Dermatology in Tucson, AZ

Active since March 02, 2026CLIA 03D0975939 · Waiver
7544 N LA CHOLLA BLVD, TUCSON, AZ 85741(520) 261-5205(520) 613-2775 Get Directions Write a Review

NPPES record last updated: September 16, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 16, 2026, Sep 10, 2026, Aug 11, 2026 and 2 more (5 updates tracked since 2026).

About Willow Dermatology, Pllc NPPES

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

WILLOW DERMATOLOGY, PLLC (NPI 1558216093) is a healthcare organization registered as a dermatology in Tucson, Arizona and active in the NPI registry since March 2026. The organization holds a CLIA Waiver certificate valid through August 18, 2028 and lists Mohammad Fazel, Owner, as its authorized official.

NPPES Registry Identity

NPI1558216093
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWILLOW DERMATOLOGY, PLLC
Location Address7544 N LA CHOLLA BLVDTucson, AZ 85741-2307
Mailing Address7544 N La Cholla BlvdTucson, AZ 85741-2307 · (520) 261-5205 · Fax (520) 613-2775
Fax(520) 613-2775
Organization SubpartNo
Authorized OfficialMohammad FazelOwner · (520) 261-5205
Enumeration DateMarch 2, 2026
Last NPPES UpdateSeptember 16, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2026
✔ NPI 1558216093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
7544 N LA CHOLLA BLVD, Tucson, AZ 85741

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0975939

Willow Dermatology · Tucson, AZ
Active · expires Aug 18, 2028
CLIA Number03D0975939
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2026
Certificate Expiration DateAugust 18, 2028
Laboratory DirectorMahdieh F. Jedlowski
Laboratory Phone(520) 261-5205
Laboratory LocationWillow Dermatology7544 N La Cholla Blvd, Tucson, AZ 85741
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Dermatology
7544 N LA CHOLLA BLVD
TUCSON, AZ 85741
Dermatology
7544 N LA CHOLLA BLVD
TUCSON, AZ 85741
Internal Medicine
7544 N LA CHOLLA BLVD
TUCSON, AZ 85741

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 Willow Dermatology, PLLC's NPI number?

The NPI number for Willow Dermatology, PLLC is 1558216093. It was assigned to this organization in the NPPES registry on March 2, 2026.

Where is Willow Dermatology, PLLC located?

Willow Dermatology, PLLC is located at 7544 N La Cholla Blvd, Tucson, AZ 85741. The listed phone number is (520) 261-5205.

What is Willow Dermatology, PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Willow Dermatology, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0975939) is associated with this NPI, valid through August 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Willow Dermatology, PLLC was last updated on September 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.