Fardad Tayebaty DMD Inc

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

100912 Issued in CA

Legal business name

FARDAD TAYEBATY DMD INC

Practice address

390 S Green Valley Rd Ste 7
Watsonville, CA 95076-3077

Phone

(831) 536-5880

NPI assigned

Oct 31, 2017

Organization subpart

No

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

Authorized official

Name

Fardad Tayebaty, DMDNPI 1396908943

Title

President

Phone

(617) 875-3211

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Fardad Tayebaty, DMD

  • Endodontics
  • Watsonville, CA
  • NPI 1396908943
  NPD (past) Authorized official

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1114439015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 VILLAGE OAKS DR APT 1408",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233778",
            "telephone_number": "617-875-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S GREEN VALLEY RD STE 7",
            "city": "WATSONVILLE",
            "state": "CA",
            "postal_code": "950763077",
            "telephone_number": "831-536-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARDAD TAYEBATY DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-31",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "TAYEBATY",
        "authorized_official_first_name": "FARDAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-875-3211",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "100912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Falcone, MFC
• Deanna Falge
• Families in Transition of Santa Cruz County
• Family Service Agency of the Central Coast
• Xin Fan, DDS
• Mehwish Farooqi, DO
• Peggy Feguson
• Felix Huerta MD a Professional
• Darrin Wes Ferguson, D.C.
• Jocelyn Ferguson

• Endodontics in Watsonville, CA
• Providers in Watsonville, CA by specialty
• Endodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2017; 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.