Keyvan Tavakoli, DDS, MDS, P.a.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN22487 Issued in FL

Legal business name

KEYVAN TAVAKOLI, DDS, MDS, P.A.

Practice address

18964 N Dale Mabry Hwy Ste 103
Lutz, FL 33548-4913

Phone

(813) 591-1568

NPI assigned

Jun 6, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Keyvan Tavakoli, DDSNPI 1285987206

Title

President

Phone

(910) 922-5707

Specialties & licenses 1

Addresses

Other names 1

• Valerian Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keyvan Tavakoli, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lutz, FL
  • NPI 1285987206
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003345802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18964 N DALE MABRY HWY STE 103",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484913",
            "telephone_number": "813-591-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18964 N DALE MABRY HWY STE 103",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484913",
            "telephone_number": "813-591-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYVAN TAVAKOLI, DDS, MDS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TAVAKOLI",
        "authorized_official_first_name": "KEYVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-922-5707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN22487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valerian Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Kester, SLP
• Victoria Lyn Ketch, DC
• Kevin Fortier DMD LLC
• Kevin J Makati MD PL
• Keystone Options, Inc
• Bahija Khaddour
• Feleisha Khan
• Nikita Khanderia, OT
• Shelby Killen
• Jae Hyun Kim, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Lutz, FL
• Providers in Lutz, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.