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General NPI Number Information
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NPI Number | 1801310131
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Entity Type | Individual
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Provider Name | TINA AN DDS
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Gender | Female
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 10 NOSBAND AVE STE 1M
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City | WHITE PLAINS
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State | NY
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Zip | 10605-2082
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Country | US
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Telephone | 646-863-5569
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Fax |
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Provider Business Mailing Address
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Address Line | 10 NOSBAND AVE
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City | WHITE PLAINS
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State | NY
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Zip | 10605-2009
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Country | US
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Telephone | 646-863-5569
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 059238
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License Number State | NY
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