Provider Demographics
NPI:1194384982
Name:TOMLINSON, RANYA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RANYA
Middle Name:
Last Name:TOMLINSON
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 1:2310 N PATTERSON ST BLDG E
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2500
Mailing Address - Country:US
Mailing Address - Phone:229-242-5511
Mailing Address - Fax:229-262-7882
Practice Address - Street 1:2310 N PATTERSON ST BLDG E
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2500
Practice Address - Country:US
Practice Address - Phone:229-242-5511
Practice Address - Fax:229-262-7882
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0158501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice