MEDICARE: DR. TULSI LALA D.M.D.

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	1223G0001X	General Practice Dentistry	7674	AZ

General Provider Information

NPI Number	:	1558517961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TULSI LALA D.M.D.

Provider Business Mailing Address
First Line	:	7131 E RANCHO VISTA DR UNIT 4006
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-1464
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 N 18TH ST
Second Line	:	STE 110
City	:	PHOENIX
State	:	AZ
Zip	:	85006-3759
Country	:	US
Telephone Number	:	602-254-3099
Fax Number	:

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

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	09/05/2021

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