Provider Demographics
NPI:1750503546
Name:ALICEA, ENIKO (DMD)
Entity Type:Individual
Prefix:DR
First Name:ENIKO
Middle Name:
Last Name:ALICEA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ENIKO
Other - Middle Name:
Other - Last Name:ALICEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:28255 N. TATUM BLVD SUITE #4
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331
Mailing Address - Country:US
Mailing Address - Phone:480-563-4141
Mailing Address - Fax:
Practice Address - Street 1:28255 N. TATUM BLVD SUITE #4
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331
Practice Address - Country:US
Practice Address - Phone:480-563-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0223221223G0001X
AZ77751223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice