Provider Demographics
NPI:1487837472
Name:ALAN SIEGEL, D.D.S., P.C.
Entity Type:Organization
Organization Name:ALAN SIEGEL, D.D.S., P.C.
Other - Org Name:SHEA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:SIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-882-1864
Mailing Address - Street 1:11111 N SCOTTSDALE RD
Mailing Address - Street 2:STE 120
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-6731
Mailing Address - Country:US
Mailing Address - Phone:480-998-3923
Mailing Address - Fax:480-922-0864
Practice Address - Street 1:11111 N SCOTTSDALE RD
Practice Address - Street 2:STE 120
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6731
Practice Address - Country:US
Practice Address - Phone:480-998-3923
Practice Address - Fax:480-922-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ38161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty