Healthcare Provider Details

I. General information

NPI: 1982396651
Provider Name (Legal Business Name): ALISHA CHADHA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 N 108TH AVE
PHOENIX AZ
85037-5463
US

IV. Provider business mailing address

865 N ARIZOLA RD
CASA GRANDE AZ
85122-6011
US

V. Phone/Fax

Practice location:
  • Phone: 623-344-2000
  • Fax:
Mailing address:
  • Phone: 520-350-7560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD012431
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: