Provider Demographics
NPI:1245758358
Name:BRIAN K TADANG DDS INC.
Entity Type:Organization
Organization Name:BRIAN K TADANG DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TADANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:657-243-1350
Mailing Address - Street 1:385 E COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-2016
Mailing Address - Country:US
Mailing Address - Phone:657-243-1350
Mailing Address - Fax:657-243-1353
Practice Address - Street 1:385 E COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-2016
Practice Address - Country:US
Practice Address - Phone:657-243-1350
Practice Address - Fax:657-243-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62700261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental