Kambiz Tavakkoli, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10837 Issued in VA

Practice address

1500 King St
Suite 300
Alexandria, VA 22314-2730

Phone

(703) 683-6688

Fax

(703) 683-6690

NPI assigned

Oct 25, 2010

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gainesville Dental Partners, PC

  • Dentist
  • Gainesville, VA
  • NPI 1730926007
  NPD
• Kambiz & Kamran Tavakkoli DMD PC

  • Dentist
  • Alexandria, VA
  • NPI 1568733566
  NPD (past)
• Old Town Dental Partners

  • General Practice Dentistry
  • Alexandria, VA
  • NPI 1740566868
  NPD (past)

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

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1326348335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 KING ST",
            "address_2": "SUITE 300",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142730",
            "telephone_number": "703-683-6688",
            "fax_number": "703-683-6690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 KING ST",
            "address_2": "SUITE 300",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142730",
            "telephone_number": "703-683-6688",
            "fax_number": "703-683-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKKOLI",
        "first_name": "KAMBIZ",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "10837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchinlema Tassew-Asmamamw, PT
• Vanessa K Tatah
• Hammad Tatari
• Susan Connor Tatum, LCSW
• Karen Taubenslag
• Kamran Tavakkoli, D.M.D
• Angela Tavolacci, BSNS
• Bibiwanhida Tawakalyar
• George W Tawil, MD
• Perdita Taylor-Zapata, M.D.

• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.