Provider Demographics
NPI:1417020413
Name:TOMLINSON, RICHARD R (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:TOMLINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6194
Mailing Address - Street 2:
Mailing Address - City:TAHOE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:96145
Mailing Address - Country:US
Mailing Address - Phone:530-583-7337
Mailing Address - Fax:
Practice Address - Street 1:140 MACKINAW ROAD
Practice Address - Street 2:
Practice Address - City:TAHOE CITY
Practice Address - State:CA
Practice Address - Zip Code:96145
Practice Address - Country:US
Practice Address - Phone:530-583-0278
Practice Address - Fax:530-583-8660
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25458OtherLIC #
CA25458OtherLIC #