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Organization
ENRIQUE TAMAYO D.D.S., INC.
Active
Organization
ENRIQUE TAMAYO D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE TAMAYO D.D.S. (OWNER)
(323) 233-9400
Entity
Organization
Contact information
Practice address
4400 S BROADWAY STE 103, LOS ANGELES, CA 90037-2792
(323) 233-9400
(323) 233-9977
Mailing address
4400 S BROADWAY STE 103, LOS ANGELES, CA 90037-2792
(323) 233-9400
(323) 233-9977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52474
DENTAL BOARD OF CALIFORNIA
CA
Enumeration date
09/14/2026
Last updated
09/14/2026
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