Provider Demographics
NPI:1174833644
Name:TSOMO, LOBSANG (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOBSANG
Middle Name:
Last Name:TSOMO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 77TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-1809
Mailing Address - Country:US
Mailing Address - Phone:857-928-5228
Mailing Address - Fax:
Practice Address - Street 1:3211 77TH ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1809
Practice Address - Country:US
Practice Address - Phone:857-928-5228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055162-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist