Provider Demographics
NPI:1962068353
Name:SON, TITUS (DDS)
Entity type:Individual
Prefix:DR
First Name:TITUS
Middle Name:
Last Name:SON
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 1:4320 E LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-5500
Mailing Address - Country:US
Mailing Address - Phone:409-892-2208
Mailing Address - Fax:409-892-4110
Practice Address - Street 1:4320 E LUCAS DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-5500
Practice Address - Country:US
Practice Address - Phone:409-892-2208
Practice Address - Fax:409-892-4110
Is Sole Proprietor?:No
Enumeration Date:2019-05-12
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363581223G0001X
NJ22DI027646001223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program