MEDICARE: DR. KARISSA HANDA DDS, MSD

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	106073	CA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-393C	NV

General Provider Information

NPI Number	:	1265924096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARISSA HANDA DDS, MSD

Provider Business Mailing Address
First Line	:	1867 ANTON WAY
Second Line	:
City	:	UPLAND
State	:	CA
Zip	:	91784-1508
Country	:	US
Telephone Number	:	909-967-8553
Fax Number	:

Provider Business Practice Location Address
First Line	:	382 W LAKE MEAD PKWY STE 130
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-7292
Country	:	US
Telephone Number	:	702-558-8543
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	10/08/2025

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