Provider Demographics
NPI:1558517961
Name:LALA, TULSI (DMD)
Entity Type:Individual
Prefix:DR
First Name:TULSI
Middle Name:
Last Name:LALA
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 1:7131 E RANCHO VISTA DR UNIT 4006
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 N 18TH ST
Practice Address - Street 2:STE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-3759
Practice Address - Country:US
Practice Address - Phone:602-254-3099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2021-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ76741223G0001X
CT99301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice