Provider Demographics
NPI:1841627825
Name:TILDEN BAY JOSEPH DENTAL GROUP
Entity type:Organization
Organization Name:TILDEN BAY JOSEPH DENTAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLER
Authorized Official - Prefix:
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-576-6143
Mailing Address - Street 1:2934 1/2 BEVERLY GLEN CIRCLE STE #451
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077
Mailing Address - Country:US
Mailing Address - Phone:323-576-6143
Mailing Address - Fax:707-639-8633
Practice Address - Street 1:14401 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-4824
Practice Address - Country:US
Practice Address - Phone:818-782-9500
Practice Address - Fax:707-639-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty