# DR. ALISSA MEDINA

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

## Provider details

- **NPI number:** 1679711444
- **Gender:** F
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22D102379900 | NJ | — |
| 1223G0001X | General Practice Dentistry | 26336 | TX | Yes |
| 1223G0001X | General Practice Dentistry | 4084-19 | MS | — |
| 1223G0001X | General Practice Dentistry | 4254 | AR | Yes |
| 1223G0001X | General Practice Dentistry | 6916 | LA | — |

## Other

- **Enumeration date:** 01/31/2009
- **Last updated:** 04/23/2026