Provider Demographics
NPI:1497796486
Name:TONN, ELVERNE MERYL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELVERNE
Middle Name:MERYL
Last Name:TONN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:ELVERNE
Other - Middle Name:MERYL
Other - Last Name:TONN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:189 N BASCOM AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1869
Mailing Address - Country:US
Mailing Address - Phone:408-286-6308
Mailing Address - Fax:408-286-6319
Practice Address - Street 1:189 N BASCOM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1869
Practice Address - Country:US
Practice Address - Phone:408-286-6308
Practice Address - Fax:408-286-6319
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry