# DR. LISA A FOGLE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104882349
- **Gender:** F
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3254 | AZ | Yes |

## Other

- **Enumeration date:** 04/25/2006
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0103480 | BLUE CROSS \# | AZ |
| 01 | — | 191092 | UNITED CONCORDIA PROVIDER | AR |
| 01 | — | 877350 | CMDP PROVIDER \# | AZ |