NPIMap

Organization Active NPI

Tavallaei DMD Corp

  • Dentist
  • Citrus Heights, CA
National Provider Identifier
1295466761
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TAVALLAEI DMD CORP
Practice address
7803 Madison Ave BLDG C Suite 700a
Citrus Heights, CA 95610
Phone
(916) 306-0333
NPI assigned
Jun 23, 2022
Last updated
Aug 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Megan Castillo
Title
Operations Manager
Phone
(916) 781-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

7803 Madison Ave BLDG C Suite 700a
Citrus Heights, CA 95610

Mailing address

2260 E Bidwell St # 314
Folsom, CA 95630-3555

National Provider Directory

National Provider Directory
Tax ID family
Make a Smile17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

7803 Madison Ave
Ste 700
Citrus Heights, CA 95610
Phone (916) 306-0333

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1295466761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST # 314",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7803 MADISON AVE BLDG C SUITE 700A",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "95610",
            "telephone_number": "916-306-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVALLAEI DMD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "916-781-6550"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Citrus Heights, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.