Provider Demographics
NPI:1528260262
Name:DUBES, MICHELLE LAI (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LAI
Last Name:DUBES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:KEM
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2323 W ROSE GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-2530
Mailing Address - Country:US
Mailing Address - Phone:602-521-6252
Mailing Address - Fax:623-842-5640
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5648
Practice Address - Country:US
Practice Address - Phone:480-425-5000
Practice Address - Fax:480-425-5010
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ412212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ429915Medicaid
Z147448OtherMEDICARE PTAN
Z147449OtherMEDICARE PTAN