Rosita Tan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

40027 Issued in CA

Practice address

4560 Admiralty Way
Ste 350
Marina del Rey, CA 90292-5423

Phone

(310) 822-8481

Fax

(310) 822-8083

NPI assigned

Mar 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1245625847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "STE 350",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-822-8481",
            "fax_number": "310-822-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "STE 350",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-822-8481",
            "fax_number": "310-822-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ROSITA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD LICENSE",
            "identifier": "40027",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Keiko Takeyasu-Ramos, PT
• Sarah Patricia Tam
• Victor Tamashiro, MD
• Scott Lee Tamura, DMD
• Ai-Yui M Tan, M.D.
• Sandy Shiaowei Tang, D.C.
• Kimberly Anne Tangen, PHD
• Dennis J. Tartakow, D.M.D., M.ED., PH.D.
• Gregg Alan Tartakow, D.M.D.
• Houman Tehrani-Vafa, PHARM.D.

• Dentist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.