Provider Demographics
NPI:1053676510
Name:TANIOS, MARIANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:TANIOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 GLENHURST AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2320
Mailing Address - Country:US
Mailing Address - Phone:323-528-2851
Mailing Address - Fax:
Practice Address - Street 1:3155 GLENHURST AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2320
Practice Address - Country:US
Practice Address - Phone:323-528-2851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program