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General NPI Number Information
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NPI Number | 1457618498
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Entity Type | Individual
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Provider Name | IGOR N TIKHONOV DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 600 S DENTON TAP RD STE 300
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City | COPPELL
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State | TX
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Zip | 75019-4533
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Country | US
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Telephone | 206-719-8396
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Fax | 972-744-3305
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Provider Business Mailing Address
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Address Line | 600 S DENTON TAP RD STE 300
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City | COPPELL
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State | TX
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Zip | 75019-4533
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Country | US
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Telephone | 206-719-8396
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 32448
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License Number State | TX
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