Provider Demographics
NPI:1679352330
Name:TAWADROUS, ROMANI SAID IBRAHIM (DDS)
Entity Type:Individual
Prefix:
First Name:ROMANI
Middle Name:SAID IBRAHIM
Last Name:TAWADROUS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E LIVE OAK AVE APT 124
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5622
Mailing Address - Country:US
Mailing Address - Phone:626-498-4720
Mailing Address - Fax:
Practice Address - Street 1:425 E LIVE OAK AVE APT 124
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5622
Practice Address - Country:US
Practice Address - Phone:626-498-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1094381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice