Individual provider Active NPI

Tatyana Romanoff, DDS

  • Dentist
  • Plano, TX
National Provider Identifier
1417221029
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
29579 Issued in TX
Practice address
4800 Hedgcoxe Rd Ste 150
Plano, TX 75024-2404
Phone
(214) 227-1000
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29579 TX Primary

Addresses

Primary practice location

4800 Hedgcoxe Rd Ste 150
Plano, TX 75024-2404

Mailing address

4205 Glen Meadows Dr
Allen, TX 75002-2741
Phone (650) 703-3490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160527000550 TX Order and Referring Only - DentistPractitioner - Dentist 9638469943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenville Smiles Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1417221029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 GLEN MEADOWS DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750022741",
            "telephone_number": "650-703-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HEDGCOXE RD STE 150",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242404",
            "telephone_number": "214-227-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOFF",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.