Provider Demographics
NPI:1639229123
Name:DELFIN TIO DDS INC.
Entity Type:Organization
Organization Name:DELFIN TIO DDS INC.
Other - Org Name:DURFEE DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-443-3915
Mailing Address - Street 1:2001 SANTA ANITA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SOUTH EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-3442
Mailing Address - Country:US
Mailing Address - Phone:626-443-3915
Mailing Address - Fax:626-444-2086
Practice Address - Street 1:2001 SANTA ANITA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SOUTH EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733-3442
Practice Address - Country:US
Practice Address - Phone:626-443-3915
Practice Address - Fax:626-444-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA239899OtherDELTA DENTAL OF CA.
CAB3989903OtherDENTI-CAL
CAG9818401OtherHEALTHY FAMILIES