Provider Demographics
NPI:1962522151
Name:TEBBI, DANIEL F (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:F
Last Name:TEBBI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16661 VENTURA BLVD
Mailing Address - Street 2:620
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436
Mailing Address - Country:US
Mailing Address - Phone:818-789-2034
Mailing Address - Fax:818-789-9505
Practice Address - Street 1:16661 VENTURA BLVD
Practice Address - Street 2:620
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-1914
Practice Address - Country:US
Practice Address - Phone:818-789-2034
Practice Address - Fax:818-789-9505
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice