Provider Demographics
NPI:1558480343
Name:TONKINSON, TIFFANI (DDS)
Entity Type:Individual
Prefix:
First Name:TIFFANI
Middle Name:
Last Name:TONKINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 N PECOS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7345
Mailing Address - Country:US
Mailing Address - Phone:702-312-9337
Mailing Address - Fax:702-990-8367
Practice Address - Street 1:72 N PECOS RD
Practice Address - Street 2:SUITE A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7345
Practice Address - Country:US
Practice Address - Phone:702-312-9337
Practice Address - Fax:702-990-8367
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV27931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice