HERITAGE TECHNOLOGIES LLC NPI 1093764938

NPI Information

  • NPI: 1093764938
  • Provider Name: HERITAGE TECHNOLOGIES, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: DESERT GROVE FAMILY MEDICAL
  • CLIA Number: 03D0930568
  • Address: 1855 N STAPLEY DR
    MESA, AZ
    ZIP 85203
  • Phone: (480) 834-7546

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NPI Details

HERITAGE TECHNOLOGIES, LLC is a family medicine in Mesa, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HERITAGE TECHNOLOGIES, LLC NPI is 1093764938. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Desert Grove Family Medical.

The provider's business location address is:

1855 N STAPLEY DR
MESA, AZ
ZIP 85203-002
Phone: (480) 834-7546
Fax: (480) 833-8313

The provider's authorized official is Michelle Dinsdale .
The authorized official title is Executive Director and has the following contact phone number (480) 834-7546.

The CLIA number assigned to this NPI record is 03D0930568 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 11/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1633795MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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