Eli Tabariai, D.M.D.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

56696 Issued in CA

Practice address

11980 San Vicente Blvd Ste 802
Los Angeles, CA 90049-6606

Phone

(310) 415-3521

Fax

(323) 544-2994

NPI assigned

Jun 19, 2008

Sex

Male

Sole proprietor

Yes

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eli Tabarai, DMD Dental Corporation, a Professional Dental Corporation

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Los Angeles, CA
  • NPI 1194041533

  Oral and Maxillofacial Surgery

  Medicare reassignment NPD Authorized official
• Southern California Hospitalist Network Medical Group Inc

  • Internal Medicine Physician
  • Orange, CA
  • NPI 1790880458
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health System Southern California

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1902844988
  Care Compare affiliation

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1437310646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24530",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900240530",
            "telephone_number": "310-415-3521",
            "fax_number": "323-544-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 802",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496606",
            "telephone_number": "310-415-3521",
            "fax_number": "323-544-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABARIAI",
        "first_name": "ELI",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "56696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazel Aimee Tabares
• Jessica Tabares
• Jesus Enrique Tabares, CMT
• Melanie Tabares
• Ebby Tabariai
• Ariel Tabarzia
• Sabeeha Tabassum
• Sajeeda Tabassum
• Ramin R Tabatabai, M.D.
• Tabernacle of Faith Baptist

• Oral & Maxillofacial Surgery (D.M.D.) in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.