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OMNI DERMATOLOGY OLIVE LLC
NPI 1669914172
Specialist in Glendale, AZ

Active since November 15, 2016
5700 W OLIVE AVE, STE 101, GLENDALE, AZ 85302(602) 559-5470(602) 559-5471 Get Directions Write a Review

NPPES record last updated: November 15, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Omni Dermatology Olive Llc NPPES

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

OMNI DERMATOLOGY OLIVE LLC (NPI 1669914172) is a healthcare organization registered as a specialist in Glendale, Arizona and active in the NPI registry since November 2016. The organization lists Andrew Joseph Racette, President, as its authorized official.

NPPES Registry Identity

NPI1669914172
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameOMNI DERMATOLOGY OLIVE LLC
Location Address5700 W OLIVE AVE, STE 101Glendale, AZ 85302-3147
Mailing Address4840 E Indian School Rd, Ste 102Phoenix, AZ 85018-5500 · (602) 954-3919 · Fax (602) 954-3670
Phone(602) 559-5470
Fax(602) 559-5471
Organization SubpartNo
Authorized OfficialAndrew Joseph RacettePresident · (602) 954-3919
Enumeration DateNovember 15, 2016
✔ NPI 1669914172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

5700 W OLIVE AVE, Glendale, AZ 85302
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 Compliance 03D1083664

Omni Dermatology Inc · Phoenix, AZ
Expired · Jun 15, 2026
CLIA Number03D1083664
Laboratory TypePhysician Office
Certificate Effective DateJune 16, 2024
Certificate Expiration DateJune 15, 2026
Laboratory DirectorAndrew Racette
Laboratory Phone(602) 954-3919
Laboratory LocationOmni Dermatology Inc4801 E Mcdowell Rd Ste 150, Phoenix, AZ 85008
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 8

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

DR. RICHARD FLEMING MARTIN DDS
Dentist (General Practice)
5700 W OLIVE AVE, SUITE 102
GLENDALE, AZ 85302
Maricopa County (623) 931-9257
REEL DENTISTRY PLLC
Preferred Provider Organization
5700 W OLIVE AVE, SUITE #104
GLENDALE, AZ 85302
Maricopa County (623) 934-7606
AZCDC,LLC
Clinic/Center (Dental)
5700 W OLIVE AVE
GLENDALE, AZ 85302
Maricopa County (480) 226-5652
DR. HENRY C. YU DMD
Dentist
5700 W OLIVE AVE, SUITE #105
GLENDALE, AZ 85302
Maricopa County (623) 334-8300
DR. HARSHAD S PATEL MD
Internal Medicine
5700 W OLIVE AVE, 108
GLENDALE, AZ 85302
Maricopa County (623) 842-3077
WSAT ENTERPRISES, LLC
Dentist
5700 W OLIVE AVE, SUITE 104
GLENDALE, AZ 85302
Maricopa County (623) 934-7606
DR HARSHAD PATEL MD PC
Internal Medicine
5700 W OLIVE AVE, STE 108
GLENDALE, AZ 85302
Maricopa County (623) 842-3077
KATHERINE CURRAN RAYMOND MT-BC
Music Therapist
5700 W OLIVE AVE
GLENDALE, AZ 85302
Maricopa County (626) 260-2410

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 Omni Dermatology Olive LLC's NPI number?

The NPI number for Omni Dermatology Olive LLC is 1669914172. It was assigned to this organization in the NPPES registry on November 15, 2016.

Where is Omni Dermatology Olive LLC located?

Omni Dermatology Olive LLC is located at 5700 W Olive Ave Ste 101, Glendale, AZ 85302. The listed phone number is (602) 559-5470.

What is Omni Dermatology Olive LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Omni Dermatology Olive LLC was last updated on November 15, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.