Provider Demographics
NPI:1366902462
Name:TOW, DEREK JOSHUA (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:JOSHUA
Last Name:TOW
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S CANON DR APT B
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3171
Mailing Address - Country:US
Mailing Address - Phone:408-891-2103
Mailing Address - Fax:
Practice Address - Street 1:8500 WILSHIRE BLVD STE 815
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3106
Practice Address - Country:US
Practice Address - Phone:626-788-2740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1047081223S0112X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery