Provider Demographics
NPI:1821095951
Name:TSUCHIYA, TODD TADAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:TADAO
Last Name:TSUCHIYA
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 1:6431 MERE DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2311
Mailing Address - Country:US
Mailing Address - Phone:952-975-0047
Mailing Address - Fax:
Practice Address - Street 1:5851 DULUTH ST
Practice Address - Street 2:STE 100
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3955
Practice Address - Country:US
Practice Address - Phone:763-546-1301
Practice Address - Fax:763-546-0905
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND101441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice