Provider Demographics
NPI:1598569113
Name:TMJ DENTAL, PLLC
Entity type:Organization
Organization Name:TMJ DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAPIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:520-572-1593
Mailing Address - Street 1:3603 W CORTARO FARMS RD STE 113
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3603 W CORTARO FARMS RD STE 113
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-1219
Practice Address - Country:US
Practice Address - Phone:520-572-1593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental