MEDICARE: DR. TINA AN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	059238	NY

General Provider Information

NPI Number	:	1801310131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TINA AN DDS

Provider Business Mailing Address
First Line	:	10 NOSBAND AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-2009
Country	:	US
Telephone Number	:	646-863-5569
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 NOSBAND AVE STE 1M
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-2082
Country	:	US
Telephone Number	:	646-863-5569
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2017
Last Update Date	:	06/14/2023

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