Active NPI
Mohammad Reza Tabatabai Irani, DDS
- General Practice Dentistry
- New Britain, CT
National Provider Identifier
1336693910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11704
- Practice address
- 446 S Main St
New Britain, CT 06051-3516 - Phone
- (860) 225-0552
- NPI assigned
- Aug 11, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11704 | CT | Primary |
Addresses
Primary practice location
446 S Main St
New Britain, CT 06051-3516
Mailing address
475 Main St Apt 2R
New York, NY 10044-0084
Phone (949) 300-3631
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11704 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470873600000",
"number": "1336693910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 MAIN ST APT 2R",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100440084",
"telephone_number": "949-300-3631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "446 S MAIN ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060513516",
"telephone_number": "860-225-0552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABATABAI IRANI",
"first_name": "MOHAMMAD REZA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-11",
"last_updated": "2016-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "11704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.