Provider Demographics
NPI:1154071587
Name:TAMBERG, ERIK (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:
Last Name:TAMBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 S SEPULVEDA BLVD APT 2716
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1865
Mailing Address - Country:US
Mailing Address - Phone:310-694-7665
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S STE 3NE1
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1197
Practice Address - Country:US
Practice Address - Phone:718-918-3419
Practice Address - Fax:718-918-6147
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program