Provider Demographics
NPI:1255037164
Name:FEDERICO TAPIA
Entity type:Organization
Organization Name:FEDERICO TAPIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTAL BILLING DEPARTMENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-209-8924
Mailing Address - Street 1:2013 DAIRY MART RD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SAN YSIDRO
Mailing Address - State:CA
Mailing Address - Zip Code:92173-1848
Mailing Address - Country:US
Mailing Address - Phone:619-209-8924
Mailing Address - Fax:
Practice Address - Street 1:BLVD GUSTAVO DIAZ ORDAZ 13251
Practice Address - Street 2:STE E11
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22106
Practice Address - Country:MX
Practice Address - Phone:921-233-1679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty