Provider Demographics
NPI:1295072734
Name:OHEBSION, TANIA SERAH (DDS)
Entity type:Individual
Prefix:DR
First Name:TANIA
Middle Name:SERAH
Last Name:OHEBSION
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S BEVERLY DR STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1152
Mailing Address - Country:US
Mailing Address - Phone:310-286-7447
Mailing Address - Fax:
Practice Address - Street 1:1125 S BEVERLY DR STE 400
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1152
Practice Address - Country:US
Practice Address - Phone:310-286-7447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice