Provider Demographics
NPI:1215131222
Name:TOOHEY, BLAIR BITTNER (DDS)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:BITTNER
Last Name:TOOHEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:BLAIR
Other - Middle Name:SUSAN
Other - Last Name:BITTNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3500 BARRANCA PKWY STE 270
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8233
Mailing Address - Country:US
Mailing Address - Phone:949-942-2002
Mailing Address - Fax:
Practice Address - Street 1:3500 BARRANCA PKWY STE 270
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8233
Practice Address - Country:US
Practice Address - Phone:949-942-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist