Provider Demographics
NPI:1962520171
Name:HUMBLE, ALISHA FERMAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ALISHA
Middle Name:FERMAN
Last Name:HUMBLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 EUCLID RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2416
Mailing Address - Country:US
Mailing Address - Phone:919-598-9900
Mailing Address - Fax:
Practice Address - Street 1:4635 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2343
Practice Address - Country:US
Practice Address - Phone:919-383-3882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNO130881223G0001X
NC99751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice