MEDICARE: LISA VOLKIN 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	1223G0001X	General Practice Dentistry	D011886	AZ

General Provider Information

NPI Number	:	1932886884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA VOLKIN DMD

Provider Business Mailing Address
First Line	:	7700 W ASPERA BLVD APT 2081
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85308-7927
Country	:	US
Telephone Number	:	215-880-9453
Fax Number	:

Provider Business Practice Location Address
First Line	:	4757 E GREENWAY RD STE 108
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-8510
Country	:	US
Telephone Number	:	602-344-9463
Fax Number	:

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

Provider Enumeration Date	:	07/03/2023
Last Update Date	:	07/03/2023

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