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General NPI Number Information
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NPI Number | 1356899470
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Entity Type | Individual
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Provider Name | TAWNY RICHARDS-COPPOLA DDS
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Gender | Female
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 08/05/2023
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Provider Practice Location Address
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Address Line | 12756 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-2309
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Country | US
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Telephone | 310-945-2416
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 462037 1125 N FAIRFAX AVE
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-9998
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Country | US
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Telephone | 424-438-4998
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Fax |
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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 | 062926
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 34545
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 105800
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 062926
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN22270
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34545
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 105800
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License Number State | CA
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