Gregg Alan Tartakow, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

54076 Issued in CA

Practice address

4712 Admiralty Way
Unit 675
Marina del Rey, CA 90292-6905

Phone

(310) 728-9230

NPI assigned

May 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1265640635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY",
            "address_2": "#675",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-728-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY",
            "address_2": "UNIT 675",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-728-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTAKOW",
        "first_name": "GREGG",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "54076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ai-Yui M Tan, M.D.
• Rosita Tan, DMD
• Sandy Shiaowei Tang, D.C.
• Kimberly Anne Tangen, PHD
• Dennis J. Tartakow, D.M.D., M.ED., PH.D.
• Houman Tehrani-Vafa, PHARM.D.
• Tana Teicheira, LCSW
• Katyayani Tejada
• Tonda Terell
• John Thomas Terrence, PSYD, PHD

• Orthodontics and Dentofacial Orthopedics Dentistry in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.