Provider Demographics
NPI:1790854727
Name:DE TOMASI, DENNIS C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:C
Last Name:DE TOMASI
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 1:1215 PLUMAS ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3455
Mailing Address - Country:US
Mailing Address - Phone:530-673-9131
Mailing Address - Fax:530-673-0162
Practice Address - Street 1:1215 PLUMAS ST
Practice Address - Street 2:STE. 300
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3455
Practice Address - Country:US
Practice Address - Phone:530-673-9131
Practice Address - Fax:530-673-0162
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA283021223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB28302-01OtherDENTI-CAL ID#
CADS0283021Medicare ID - Type Unspecified
CAT08905Medicare UPIN