Provider Demographics
NPI:1407630213
Name:TSERING, TASHI WILLIAM
Entity Type:Individual
Prefix:
First Name:TASHI
Middle Name:WILLIAM
Last Name:TSERING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 MAPLE ST W
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-4438
Mailing Address - Country:US
Mailing Address - Phone:651-491-7352
Mailing Address - Fax:
Practice Address - Street 1:925 HIGHWAY 55 STE 102
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3735
Practice Address - Country:US
Practice Address - Phone:651-437-7844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND149881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice