MEDICARE: DR. ALEN MADADI 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	1223P0700X	Prosthodontics	D5324	AZ

General Provider Information

NPI Number	:	1457555732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEN MADADI DMD

Provider Business Mailing Address
First Line	:	4955 N SABINO CANYON RD STE 103
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6491
Country	:	US
Telephone Number	:	520-299-5122
Fax Number	:	520-232-9015

Provider Business Practice Location Address
First Line	:	4955 N SABINO CANYON RD STE 103
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85750-6491
Country	:	US
Telephone Number	:	520-299-5122
Fax Number	:	520-232-9015

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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