Provider Demographics
NPI:1316676174
Name:RIFILATO, ALYSSA LOREN (DDS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LOREN
Last Name:RIFILATO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 CAPITOL BLVD SE FL 1
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-8520
Mailing Address - Country:US
Mailing Address - Phone:360-522-9070
Mailing Address - Fax:360-522-9077
Practice Address - Street 1:6004 CAPITOL BLVD SE FL 1
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-8520
Practice Address - Country:US
Practice Address - Phone:360-522-9070
Practice Address - Fax:360-522-9077
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE61538300122300000X, 1223G0001X
CA205316116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist