Azadeh Tavari, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

101690 Issued in CA

Practice address

11633 San Vicente Blvd
Los Angeles, CA 90049-6511

Phone

(818) 324-6121

NPI assigned

Aug 31, 2017

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1487172391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18160 CHARDON CIR",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164415",
            "telephone_number": "818-324-6121",
            "fax_number": "818-324-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11633 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496511",
            "telephone_number": "818-324-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARI",
        "first_name": "AZADEH",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "101690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amin Tavakoli, MD
• Jonathan Tavakoli, DPM
• Daria Tavana
• Laisha Tavares
• Marielle Tavares
• Javid D Tavari, D.O.
• Shaghayegh Tavassoli, D.O.
• Michael Lewis Tave, H.S.
• Natasha Monique Tave
• Sabrina Tavera

• Periodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.