Provider Demographics
NPI:1265209993
Name:DENTAL ANESTHESIA SPECIALISTS PLLC
Entity type:Organization
Organization Name:DENTAL ANESTHESIA SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DMD
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:C
Authorized Official - Last Name:TOMKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-221-5080
Mailing Address - Street 1:474 W STRIDING EDGE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7091
Mailing Address - Country:US
Mailing Address - Phone:480-221-5080
Mailing Address - Fax:
Practice Address - Street 1:519 W JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6519
Practice Address - Country:US
Practice Address - Phone:480-221-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0004XDental ProvidersDentistDental AnesthesiologyGroup - Single Specialty