DESERT DERMATOLOGY AND SURGERY LLC — NPI 1902626047 (Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) in IVINS, UT)

CMS-1500 Box 24J / 33a • NPI

1902626047

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

207ND0101X (CMS 07)

Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)

Box 32 Service Location & ZIP+4

272 E CENTER ST STE 102, IVINS, UT, 84738-6456

✓ 9-Digit EDI 837 ZIP+4 (84738-6456)

Practice Phone & Referral Fax

(307) 413-3752

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1902626047 (DESERT DERMATOLOGY AND SURGERY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1902626047` (NPI-2 Organization / Facility)
Provider / Legal Name	DESERT DERMATOLOGY AND SURGERY LLC
Plain-English Specialty	Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: `207ND0101X` (Dermatology, MOHS-Micrographic Surgery)
Certifying / Licensing Body	American Board of Dermatology (ABD)
Practice Location Address	272 E CENTER ST STE 102, IVINS, UT, 84738-6456
Practice Telephone / Fax	Tel: (307) 413-3752
Administrative Mailing Address	756 W SHINAVA DR, IVINS, UT, 84738-6713
Enumeration & Last Sync	Enumerated: 2024-10-14 \| CMS Record Updated: 2024-10-14
Authorized Official	CHRISTIAN ANDERSON (Physician Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

272 E CENTER ST STE 102, IVINS, UT, 84738-6456

🗺️ Open in Google Maps 🏥 More Providers in IVINS

🔒 Are you DESERT DERMATOLOGY AND SURGERY LLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (207ND0101X)

What Does Taxonomy Code 207ND0101X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207ND0101X translates to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 07 (Physician/Dermatology) • CMS Code D7 (Micrographic Dermatologic Surgery)
Certifying / Accrediting Authority: American Board of Dermatology (ABD)
Clinical Scope: Changing moles, skin rashes, severe acne, eczema, psoriasis, fungal infections, hair loss, or skin cancer checks.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DESERT DERMATOLOGY AND SURGERY LLC)

Typical CPT / Diagnostic Procedures:

Full-Body Dermoscopy & Skin Cancer Screening
Shave, Punch & Excisional Skin Biopsy (CPT 11102–11107)
Cryotherapy Destruction of Actinic Keratoses & Viral Warts (CPT 17000)

Common Therapeutic Classes:

Topical Corticosteroids (Triamcinolone, Clobetasol) & Calcineurin Inhibitors
Topical & Oral Retinoids (Tretinoin, Adapalene, Isotretinoin)
Doxycycline, Minocycline & Antifungals (Terbinafine, Ketoconazole)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207ND0101X` — Dermatology, MOHS-Micrographic Surgery Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

DESERT DERMATOLOGY AND SURGERY LLC (NPI #1902626047)