Provider Demographics
NPI:1538052295
Name:TINGEY, KIAN
Entity type:Individual
Prefix:
First Name:KIAN
Middle Name:
Last Name:TINGEY
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:KIAN
Other - Middle Name:
Other - Last Name:TINGEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:7022 W MAYA WAY
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-5564
Mailing Address - Country:US
Mailing Address - Phone:425-985-6003
Mailing Address - Fax:
Practice Address - Street 1:8345 W THUNDERBIRD RD STE B100
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3668
Practice Address - Country:US
Practice Address - Phone:602-943-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0125121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice