Provider Demographics
NPI:1205406824
Name:ARORA, LIZA
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:ARORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 LAKESIDE DR APT 1080
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-1027
Mailing Address - Country:US
Mailing Address - Phone:469-450-7741
Mailing Address - Fax:
Practice Address - Street 1:ALAMO SMILES DENTAL GROUP
Practice Address - Street 2:3000DANVILLE BLVD STE A&B
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507
Practice Address - Country:US
Practice Address - Phone:925-820-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-26
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1072661223G0001X
IL019.0332261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice