Provider Demographics
NPI:1174714075
Name:FURKIOTI, DEAN A (DDS)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:A
Last Name:FURKIOTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 VISTA DEL MAR
Mailing Address - Street 2:#B
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277
Mailing Address - Country:US
Mailing Address - Phone:310-540-4882
Mailing Address - Fax:310-540-6607
Practice Address - Street 1:220 VISTA DEL MAR
Practice Address - Street 2:#B
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277
Practice Address - Country:US
Practice Address - Phone:310-540-4882
Practice Address - Fax:310-540-6607
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30158122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist