Provider Demographics
NPI:1245493048
Name:ONJUKKA, TOMMY R (DDS)
Entity type:Individual
Prefix:DR
First Name:TOMMY
Middle Name:R
Last Name:ONJUKKA
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 1:627 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1367
Mailing Address - Country:US
Mailing Address - Phone:678-882-2625
Mailing Address - Fax:
Practice Address - Street 1:627 E 1ST ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1367
Practice Address - Country:US
Practice Address - Phone:678-882-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016164122300000X
OH30.0248481223D0001X
WI7186122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health