Provider Demographics
NPI:1396810909
Name:GOOD SOUND AUDIOLOGY PLLC
Entity type:Organization
Organization Name:GOOD SOUND AUDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TINA
Authorized Official - Middle Name:JANEEN
Authorized Official - Last Name:JESSEE
Authorized Official - Suffix:
Authorized Official - Credentials:AU D
Authorized Official - Phone:480-497-0780
Mailing Address - Street 1:201 W GUADALUPE RD
Mailing Address - Street 2:SUITE 315
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3332
Mailing Address - Country:US
Mailing Address - Phone:480-497-0780
Mailing Address - Fax:480-497-0790
Practice Address - Street 1:201 W GUADALUPE RD
Practice Address - Street 2:SUITE 315
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3332
Practice Address - Country:US
Practice Address - Phone:480-497-0780
Practice Address - Fax:480-497-0790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA0060237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ981622Medicaid
AZ2Z4495OtherHEALTHNET ID NUMBER
AZAZ0902910OtherBCBS ID NUMBER
AZ2892231OtherAETNA ID NUMBER
AZ2892231OtherAETNA ID NUMBER
AZS63571Medicare UPIN