Provider Demographics
NPI:1932294808
Name:TANNYHILL, WILLIAM MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:TANNYHILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:MICHAEL
Other - Last Name:TANNYHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8152 PAINTER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3756
Mailing Address - Country:US
Mailing Address - Phone:562-698-8272
Mailing Address - Fax:562-693-0504
Practice Address - Street 1:8152 PAINTER AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3756
Practice Address - Country:US
Practice Address - Phone:562-698-8272
Practice Address - Fax:562-693-0504
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
952860711OtherIRS ITIN