Provider Demographics
NPI:1013355783
Name:GIACOMINI, TONI (RDHAP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:GIACOMINI
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34041 COLEGIO DR
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-2652
Mailing Address - Country:US
Mailing Address - Phone:949-366-6069
Mailing Address - Fax:
Practice Address - Street 1:34041 COLEGIO DR
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2652
Practice Address - Country:US
Practice Address - Phone:949-366-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA469124Q00000X
CA012354124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist