Tavakolian DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TAVAKOLIAN DDS, INC.

Practice address

2041 Pioneer CT Ste 100
San Mateo, CA 94403-1729

Phone

(240) 750-9239

NPI assigned

Jul 30, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Pardis Tavakolian, DDSNPI 1932656949

Title

President

Phone

(240) 750-9239

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Pardis Tavakolian

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1932656949
  NPD Authorized official
• Hiroyuki Arima, DMD

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1487706867
  NPD (past)
• Stacey Bichdao Bui, DDS

  • General Practice Dentistry
  • San Mateo, CA
  • NPI 1669765228
  NPD (past)

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

{
    "created_epoch": "1659139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668902400000",
    "number": "1104552231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 PIONEER CT STE 100",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031729",
            "telephone_number": "650-573-0628",
            "fax_number": "650-345-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 PIONEER CT STE 100",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031729",
            "telephone_number": "240-750-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVAKOLIAN DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-11-20",
        "certification_date": "2022-11-20",
        "status": "A",
        "authorized_official_last_name": "TAVAKOLIAN",
        "authorized_official_first_name": "PARDIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-750-9239",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1932656949",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory John Tarasoff, MD
• Andrew Tardiff, PSYD
• Karren P Tart, L.AC.
• Tina Tat
• William Reeves Tatomer, MD
• Pardis Tavakolian
• Daniel Taw, DMD
• Carrie Taylor
• Shardae Taylor
• Justin Phillip Tays

• Dental Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.