Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Licauco Tan Dental Corp

Organization Dentist · NPI 1952431033

Licauco Tan Dental Corp provides Dentist services in LA Palma, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

30 Centerpointe Dr Ste 10
LA Palma, CA 90623-1055
Phone: (714) 994-0888
Fax: (714) 994-6038
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 40656 (CA)
Dentist Taxonomy 122300000X · Licence 41314 (CA)

Record details

NPI number1952431033
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cecile Licauco — President · (714) 994-0888
NPI enumeratedMarch 7, 2007
Last updated in NPPESAugust 22, 2020
Mailing address30 Centerpointe Dr, Suite 10, La Palma, CA 90623-1055

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