Individual provider Active NPI

Thameaneh Tabatabaeifar, DDS

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1003593542
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN2000282 Issued in DC
Practice address
5225 Wisconsin Ave NW Ste 511
Washington, DC 20015-2024
Phone
(202) 966-0620
NPI assigned
Jun 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DEN2000282 DC Primary

Addresses

Primary practice location

5225 Wisconsin Ave NW Ste 511
Washington, DC 20015-2024

Mailing address

5 Webb Rd
Cabin John, MD 20818-1807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DEN2000282DCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Carol a Blake, DDS, PLLC PastSince Jul 2, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1003593542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WEBB RD",
            "city": "CABIN JOHN",
            "state": "MD",
            "postal_code": "208181807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 WISCONSIN AVE NW STE 511",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152024",
            "telephone_number": "202-966-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABATABAEIFAR",
        "first_name": "THAMEANEH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN2000282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.