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General NPI Number Information
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NPI Number | 1205284239
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Entity Type | Individual
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Provider Name | TATYANA A STRAUS DMD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 1207 CHESTNUT ST 4TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4131
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Country | US
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Telephone | 215-525-3046
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Fax | 215-567-1617
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Provider Business Mailing Address
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Address Line | 1233 LOCUST ST 3RD FL
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5400
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Country | US
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Telephone | 215-985-4448
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Fax | 215-732-1478
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS040822
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS040822
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License Number State | PA
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