Provider Demographics
NPI:1437350089
Name:DANIEL F TEBBI DMD INC
Entity Type:Organization
Organization Name:DANIEL F TEBBI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:TEBBI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD INC
Authorized Official - Phone:818-789-2034
Mailing Address - Street 1:16661 VENTURA BLVD
Mailing Address - Street 2:620
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-1914
Mailing Address - Country:US
Mailing Address - Phone:818-789-2034
Mailing Address - Fax:818-789-9505
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:620
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:818-789-2034
Practice Address - Fax:818-789-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962522151OtherNPI