Provider Demographics
NPI:1861416935
Name:TANPIENGCO, EDWIN MONTANO (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:MONTANO
Last Name:TANPIENGCO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 GEORGES ROAD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852
Mailing Address - Country:US
Mailing Address - Phone:732-951-0099
Mailing Address - Fax:732-951-2323
Practice Address - Street 1:886 GEORGES ROAD
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852
Practice Address - Country:US
Practice Address - Phone:732-951-0099
Practice Address - Fax:732-951-2323
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ170261223G0001X
NY042323-11223G0001X
NJ22DI017026001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice