Healthcare Provider Details

I. General information

NPI: 1528985355
Provider Name (Legal Business Name): ALISHA ABBAS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 E TANQUE VERDE RD STE 107
TUCSON AZ
85715-3484
US

IV. Provider business mailing address

7111 E TANQUE VERDE RD STE 107
TUCSON AZ
85715-3484
US

V. Phone/Fax

Practice location:
  • Phone: 520-318-4455
  • Fax:
Mailing address:
  • Phone: 520-318-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD012896
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: