Provider Demographics
NPI:1801102389
Name:TUNGOL, DIANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:
Last Name:TUNGOL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6961 SCHAEFER AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-9126
Mailing Address - Country:US
Mailing Address - Phone:909-590-0640
Mailing Address - Fax:
Practice Address - Street 1:8856 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-1365
Practice Address - Country:US
Practice Address - Phone:951-710-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist