Individual provider Active NPI

Tasneem Nabelsi, DDS

  • Dentist
  • Garden Grove, CA
National Provider Identifier
1174078208
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100678 Issued in CA
Practice address
11101 Brookhurst St
Garden Grove, CA 92840-1002
Phone
(714) 590-1200
Fax
(714) 534-5510
NPI assigned
Aug 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100678 CA Primary

Addresses

Primary practice location

11101 Brookhurst St
Garden Grove, CA 92840-1002

Mailing address

11101 Brookhurst St
Garden Grove, CA 92840-1002
Phone (714) 590-1200

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
100678CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tasneem Nabelsi DDS Inc Dentist Past 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": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1174078208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928401002",
            "telephone_number": "714-590-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 BROOKHURST ST",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928401002",
            "telephone_number": "714-590-1200",
            "fax_number": "714-534-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABELSI",
        "first_name": "TASNEEM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.