Provider Demographics
NPI:1669107009
Name:LITTLE TOOTH DOCTORS LLC
Entity type:Organization
Organization Name:LITTLE TOOTH DOCTORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:323-434-9209
Mailing Address - Street 1:51 HUNTFIELD DRIVE SUITE 100
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977
Mailing Address - Country:US
Mailing Address - Phone:302-508-0037
Mailing Address - Fax:
Practice Address - Street 1:51 HUNTFIELD DRIVE
Practice Address - Street 2:100
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977
Practice Address - Country:US
Practice Address - Phone:302-508-0037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE TOOTH DOCTORS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE8816255957Medicaid