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General NPI Number Information
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NPI Number | 1619406857
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Entity Type | Individual
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Provider Name | JELENA LAMACCHIA DDS
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Gender | Female
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Dates
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Enumeration Date | 06/10/2017
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 8438 E SHEA BLVD STE 100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-6669
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Country | US
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Telephone | 480-661-7745
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Fax |
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Provider Business Mailing Address
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Address Line | 23963 N 77TH WAY
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-6153
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Country | US
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Telephone | 262-960-2783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 009770
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D009770
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License Number State | AZ
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