Provider Demographics
NPI:1477641157
Name:ACIERNO, THOMAS G (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:ACIERNO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3867 CLAIREMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5831
Mailing Address - Country:US
Mailing Address - Phone:619-276-5526
Mailing Address - Fax:619-276-5527
Practice Address - Street 1:3867 CLAIREMONT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5831
Practice Address - Country:US
Practice Address - Phone:619-276-5526
Practice Address - Fax:619-276-5527
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA342841223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA986357Medicare UPIN
CA267583Medicare UPIN