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General NPI Number Information
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NPI Number | 1841627825
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Entity Type | Organization
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Legal Business Name | TILDEN BAY JOSEPH DENTAL GROUP
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 14401 BURBANK BLVD
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City | SHERMAN OAKS
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State | CA
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Zip | 91401-4824
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Country | US
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Telephone | 818-782-9500
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Fax | 707-639-8633
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Provider Business Mailing Address
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Address Line | 2934 1/2 BEVERLY GLEN CIRCLE STE #451
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City | LOS ANGELES
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State | CA
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Zip | 90077
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Country | US
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Telephone | 323-576-6143
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Fax | 707-639-8633
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Authorized Official
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Title or Position | INSURANCE BILLER
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Name | YOLANDA CARO
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Credential |
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Telephone | 323-576-6143
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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 |
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License Number State |
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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 |
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License Number State |
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