Provider Demographics
NPI:1881065498
Name:TIONGSON, JOANE KAY L (RDH, RDHAP)
Entity type:Individual
Prefix:
First Name:JOANE KAY
Middle Name:L
Last Name:TIONGSON
Suffix:
Gender:F
Credentials:RDH, RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 TURQUOISE ST
Mailing Address - Street 2:UNIT 123
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-1135
Mailing Address - Country:US
Mailing Address - Phone:714-883-7323
Mailing Address - Fax:
Practice Address - Street 1:860 TURQUOISE ST
Practice Address - Street 2:UNIT 123
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-1135
Practice Address - Country:US
Practice Address - Phone:714-883-7323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA571 (HAP)124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist