Healthcare Provider Details

I. General information

NPI: 1245144567
Provider Name (Legal Business Name): ALISON PARK RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 N WILMOT RD STE B
TUCSON AZ
85711-1712
US

IV. Provider business mailing address

9841 S CAMINO DE LA CALINDA
VAIL AZ
85641-2042
US

V. Phone/Fax

Practice location:
  • Phone: 520-682-4111
  • Fax: 520-290-8997
Mailing address:
  • Phone: 951-743-4664
  • Fax: 520-682-3817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH010382
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: