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Banner Physician Super Specialists Arizona LLC

Nutrition Education Nutritionist in Mesa, AZ · enumerated 2019 · authorized official Dennis Laraway, Cfo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1790337665

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Registry record

Entity type Organization (Type 2)
Legal business name Banner Physician Super Specialists Arizona LLC
Parent organization Banner Health
Practice address 1450 S Dobson Rd Ste B221, Mesa, AZ, 85202
Phone (480) 827-5370
Enumeration date Jul 11, 2019
Last updated in NPPES Dec 28, 2021

Taxonomy & classification

133NN1002X Nutrition Education Nutritionist Dietary & Nutritional Service Providers Primary
261QM1300X Multi-Specialty Clinic/Center Ambulatory Health Care Facilities Secondary

Authorized official

Name Dennis Laraway
Title Cfo
Phone (602) 747-4000

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2021-12-28. Verify at npiregistry.cms.hhs.gov.
Where is Banner Physician Super Specialists Arizona LLC located?
The practice location on file with NPPES is in Mesa, AZ.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-12-28.