Healthcare Provider Details

I. General information

NPI: 1417880345
Provider Name (Legal Business Name): ELAINE ANNE ARCIAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 N 43RD AVE
PHOENIX AZ
85051-5712
US

IV. Provider business mailing address

5345 E HILTON AVE
MESA AZ
85206-5515
US

V. Phone/Fax

Practice location:
  • Phone: 602-888-7844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012848
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: