MEDICARE: DR. TITO MOLINA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	25516	TX
2	1223G0001X	General Practice Dentistry	58476	CA
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	11313	SC

General Provider Information

NPI Number	:	1801026273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TITO MOLINA DDS

Provider Business Mailing Address
First Line	:	23226 WILLOW CANYON DR
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-3526
Country	:	US
Telephone Number	:	310-213-9414
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 REED AVE
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29072
Country	:	US
Telephone Number	:	803-957-6113
Fax Number	:	803-957-5290

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	06/19/2026

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