Provider Demographics
NPI:1528131174
Name:BIALA, FE TIONGSON (DMD)
Entity type:Individual
Prefix:DR
First Name:FE
Middle Name:TIONGSON
Last Name:BIALA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 W CALAVERAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5201
Mailing Address - Country:US
Mailing Address - Phone:408-946-1600
Mailing Address - Fax:408-946-3300
Practice Address - Street 1:141 W CALAVERAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5201
Practice Address - Country:US
Practice Address - Phone:408-946-1600
Practice Address - Fax:408-946-3300
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA415591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4155901OtherNPI - DENTICAL
CAD41559Medicaid