Provider Demographics
NPI:1386845105
Name:TABIOLO, RENEE ANN SARNO (DMD)
Entity Type:Individual
Prefix:DR
First Name:RENEE ANN
Middle Name:SARNO
Last Name:TABIOLO
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 1:2340 MCKEE RD
Mailing Address - Street 2:#23
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1615
Mailing Address - Country:US
Mailing Address - Phone:408-259-1053
Mailing Address - Fax:
Practice Address - Street 1:2340 MCKEE RD
Practice Address - Street 2:#23
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1615
Practice Address - Country:US
Practice Address - Phone:408-259-1053
Practice Address - Fax:408-259-0115
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice