Provider Demographics
NPI:1437776812
Name:ANDY L. TIEU DDS, INC.
Entity type:Organization
Organization Name:ANDY L. TIEU DDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:TIEU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-831-0707
Mailing Address - Street 1:6790 TOP GUN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:858-831-0707
Mailing Address - Fax:858-831-0770
Practice Address - Street 1:6790 TOP GUN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121
Practice Address - Country:US
Practice Address - Phone:858-831-0707
Practice Address - Fax:858-831-0770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANDY L. TIEU DDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-01
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental