MEDICARE: VICTORIA TON 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	DEN.00204482	CO
2	1223G0001X	General Practice Dentistry	D11393	OR

General Provider Information

NPI Number	:	1801406087
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA TON DDS

Provider Business Mailing Address
First Line	:	12301 W PICO BLVD APT 303
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1196
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3347 NEW CENTER PT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-2880
Country	:	US
Telephone Number	:	719-208-3791
Fax Number	:

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

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	01/11/2026

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Directions to “ VICTORIA TON DDS” Practice Location

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