Provider Demographics
NPI:1669968228
Name:TAWADROUS, JOY AFRAIEM (DMD)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:AFRAIEM
Last Name:TAWADROUS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11346 AGNES ST
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6504
Mailing Address - Country:US
Mailing Address - Phone:562-213-3863
Mailing Address - Fax:
Practice Address - Street 1:1101 TRUMAN ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3237
Practice Address - Country:US
Practice Address - Phone:855-203-6053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-07
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1025621223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics