Healthcare Provider Details

I. General information

NPI: 1407890056
Provider Name (Legal Business Name): TAMMIE LAJUANA ADAMS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMMIE LAJUANA ADAMS DMD

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20707 ANZA AVE APT # 271
TORRANCE CA
90503-2925
US

IV. Provider business mailing address

2604 S VERMONT AVE SUITE F
LOS ANGELES CA
90007-2298
US

V. Phone/Fax

Practice location:
  • Phone: 424-247-7235
  • Fax:
Mailing address:
  • Phone: 323-731-3333
  • Fax: 323-731-7626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3094
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number56262CA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: