Provider Demographics
NPI:1356216121
Name:LUMAN, ALISHA LOVE (RDH)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:LOVE
Last Name:LUMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 LUDWIG DR
Mailing Address - Street 2:
Mailing Address - City:BAYFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:81122-9397
Mailing Address - Country:US
Mailing Address - Phone:480-231-0774
Mailing Address - Fax:
Practice Address - Street 1:104 E MAIN STREET
Practice Address - Street 2:UNIT 1
Practice Address - City:BAYFIELD
Practice Address - State:CO
Practice Address - Zip Code:81122
Practice Address - Country:US
Practice Address - Phone:480-231-0774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002025945124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist