# THEODORE A TANABE DDS A PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730489014
- **Authorized official:** DR. THEODORE A TANABE DDS (PRESIDENT)
- **Authorized official phone:** (562) 698-0387

## Contact information

- **Practice address:** 13203 HADLEY STREET, SUITE 101, WHITTIER, CA 90601
- **Practice address phone:** (562) 698-0387
- **Practice address fax:** (562) 696-7677
- **Mailing address:** 13203 HADLEY STREET, SUITE 101, WHITTIER, CA 90601
- **Mailing address phone:** (562) 698-0387
- **Mailing address fax:** (562) 896-7677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 39716 | CA | Yes |
| 261QS0112X | Oral and Maxillofacial Surgery Clinic/Center | 39716 | CA | — |

## Other

- **Enumeration date:** 11/02/2010
- **Last updated:** 12/26/2017