Provider Demographics
NPI:1699379545
Name:TUNALI, IMAN (RDH)
Entity Type:Individual
Prefix:
First Name:IMAN
Middle Name:
Last Name:TUNALI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 TWILIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7414
Mailing Address - Country:US
Mailing Address - Phone:407-655-9059
Mailing Address - Fax:
Practice Address - Street 1:3385 S US HIGHWAY 17/92 STE 221
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-2916
Practice Address - Country:US
Practice Address - Phone:407-831-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24870124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist