Individual provider Active NPI

Laleh Tavabi, DDS

  • Dentist
  • Long Beach, NY
National Provider Identifier
1457535502
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0485291 Issued in NY
Practice address
324 West Park Ave
Long Beach, NY 11561-3213
Phone
(516) 432-2837
Fax
(516) 432-6319
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0485291 NY Primary

Addresses

Primary practice location

324 West Park Ave
Long Beach, NY 11561-3213

Mailing address

324 West Park Ave
Long Beach, NY 11561-3213
Phone (516) 432-2837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 16, 2016 through Mar 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0485291NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1457535502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 WEST PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613213",
            "telephone_number": "516-432-2837",
            "fax_number": "516-432-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 WEST PARK AVE",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115613213",
            "telephone_number": "516-432-2837",
            "fax_number": "516-432-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVABI",
        "first_name": "LALEH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0485291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, NY

Sources for this page

Verify at the official NPI Registry.