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: August 16, 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
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

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

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.

Music Therapist
5700 W OLIVE AVE
GLENDALE, AZ 85302
Dentist
5700 W OLIVE AVE, SUITE 104
GLENDALE, AZ 85302
Dentist
5700 W OLIVE AVE, SUITE #105
GLENDALE, AZ 85302
Internal Medicine
5700 W OLIVE AVE, 108
GLENDALE, AZ 85302
Preferred Provider Organization
5700 W OLIVE AVE, SUITE #104
GLENDALE, AZ 85302
Dentist (General Practice)
5700 W OLIVE AVE, SUITE 102
GLENDALE, AZ 85302
Clinic/Center (Dental)
5700 W OLIVE AVE
GLENDALE, AZ 85302
Internal Medicine
5700 W OLIVE AVE, STE 108
GLENDALE, AZ 85302

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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.