Provider Demographics
NPI:1316274111
Name:TSAI, COLLIN G (DDS)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:G
Last Name:TSAI
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 1:8247 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2527
Mailing Address - Country:US
Mailing Address - Phone:323-724-3800
Mailing Address - Fax:323-722-4892
Practice Address - Street 1:8247 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660
Practice Address - Country:US
Practice Address - Phone:323-724-3800
Practice Address - Fax:323-722-4892
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA589831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics