Provider Demographics
NPI:1285814913
Name:HWIEBENG & LIANIEN TJIONG DDS
Entity Type:Organization
Organization Name:HWIEBENG & LIANIEN TJIONG DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIA
Authorized Official - Middle Name:LIAN IEN
Authorized Official - Last Name:TJIONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-342-2901
Mailing Address - Street 1:7407 RESEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-2819
Mailing Address - Country:US
Mailing Address - Phone:818-342-2901
Mailing Address - Fax:818-774-1023
Practice Address - Street 1:7407 RESEDA BLVD
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-2819
Practice Address - Country:US
Practice Address - Phone:818-342-2901
Practice Address - Fax:818-774-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27389Medicaid