Provider Demographics
NPI:1578361754
Name:TORRES, TAHINA CHANEL (DMD)
Entity type:Individual
Prefix:
First Name:TAHINA
Middle Name:CHANEL
Last Name:TORRES
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631 CASS ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3623
Mailing Address - Country:US
Mailing Address - Phone:402-393-0594
Mailing Address - Fax:402-391-1356
Practice Address - Street 1:7631 CASS ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3623
Practice Address - Country:US
Practice Address - Phone:813-940-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN274381223X0400X
NE80641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics