MEDICARE: MASSIA ATALLA

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
1	1223G0001X	General Practice Dentistry	D012864.	AZ

General Provider Information

NPI Number	:	1952236549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MASSIA ATALLA

Provider Business Mailing Address
First Line	:	1536 E APOLLO RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-4466
Country	:	US
Telephone Number	:	480-469-7615
Fax Number	:

Provider Business Practice Location Address
First Line	:	7710 W LOWER BUCKEYE RD STE 120
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85043-3439
Country	:	US
Telephone Number	:	623-387-9101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ MASSIA ATALLA ” Practice Location

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