MEDICARE: ELIZAVETA HAMANN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30024556	OH

General Provider Information

NPI Number	:	1215310461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZAVETA HAMANN DMD

Provider Business Mailing Address
First Line	:	4235 N 32ND ST STE C
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-4766
Country	:	US
Telephone Number	:	602-951-2411
Fax Number	:

Provider Business Practice Location Address
First Line	:	4235 N 32ND ST STE C
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-4766
Country	:	US
Telephone Number	:	602-957-2411
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2015
Last Update Date	:	01/14/2026

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