Provider Demographics
NPI:1548309677
Name:MOE, THOMAS KYAW (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KYAW
Last Name:MOE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MAUNG
Other - Middle Name:KYAW
Other - Last Name:MOE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1237 S 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-4422
Mailing Address - Country:US
Mailing Address - Phone:626-898-4649
Mailing Address - Fax:626-898-4649
Practice Address - Street 1:1237 S 9TH AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5044
Practice Address - Country:US
Practice Address - Phone:626-348-8149
Practice Address - Fax:626-348-8149
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA552061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice