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NPI Code Detail

MEDICARE: PRACHI TYAGI

MEDICARE:   PRACHI  TYAGI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD010508AZ

General Provider Information

NPI Number : 1053797357
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRACHI TYAGI
Provider Business Mailing Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD STE 165A
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 402-551-9533
Fax Number :
Provider Business Practice Location Address
First Line : 14858 N FRANK LLOYD WRIGHT BLVD BLDG 260
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-2216
Country : US
Telephone Number : 480-860-4455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2015
Last Update Date : 02/12/2020

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Directions to “ PRACHI TYAGI ” Practice Location

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