Provider Demographics
NPI:1598093643
Name:TIEP, SAMBATH SEM (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMBATH
Middle Name:SEM
Last Name:TIEP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15725 POMERADO RD STE 206
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2059
Mailing Address - Country:US
Mailing Address - Phone:858-251-3313
Mailing Address - Fax:858-225-1803
Practice Address - Street 1:15725 POMERADO RD STE 206
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2059
Practice Address - Country:US
Practice Address - Phone:858-251-3313
Practice Address - Fax:858-225-1803
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA589161223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry