Provider Demographics
NPI:1154686228
Name:TAWADY, TONTESH SHIVAKUMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:TONTESH
Middle Name:SHIVAKUMAR
Last Name:TAWADY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1206 YORK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6217
Mailing Address - Country:US
Mailing Address - Phone:410-821-5553
Mailing Address - Fax:410-825-7213
Practice Address - Street 1:1206 YORK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6217
Practice Address - Country:US
Practice Address - Phone:410-821-5553
Practice Address - Fax:410-825-7213
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD157271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics