Provider Demographics
NPI:1528549730
Name:FISHMAN, ALISON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:FISHMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VAN NESS AVE APT 1603
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5223
Mailing Address - Country:US
Mailing Address - Phone:214-263-8440
Mailing Address - Fax:
Practice Address - Street 1:160 BOVET RD STE 307
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3138
Practice Address - Country:US
Practice Address - Phone:650-630-1006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1023291223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics