Provider Demographics
NPI:1770880569
Name:PAIVA, TIFFANY WING-YAN WOO (DMD)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:WING-YAN WOO
Last Name:PAIVA
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 1:1005 W 38TH ST
Mailing Address - Street 2:#100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1041
Mailing Address - Country:US
Mailing Address - Phone:512-615-0100
Mailing Address - Fax:
Practice Address - Street 1:1005 W 38TH ST
Practice Address - Street 2:#100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1041
Practice Address - Country:US
Practice Address - Phone:512-615-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice