Individual provider · Type 1 NPI

Pethan Tin, DDS

Oral and Maxillofacial Surgery (Dentist) · Bronx, NY

NPI number 1669428041 Active

Practice location

1940 Grand Concourse
Bronx, NY 10457-5221

Call (718) 583-6347 Map

Fax (718) 583-8047

Mailing address

120 W 86th St
New York, NY 10024-4021

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X052227 (NY)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1669428041

Pethan Tin, DDS's National Provider Identifier is 1669428041, issued on May 26, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Bronx, NY. The record was last updated on Jul 13, 2026.