Individual provider Active NPI

Kenan Tarabishy, D.D.S.

  • Dentist
  • Tampa, FL
National Provider Identifier
1508102021
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019028915 Issued in IL
Practice address
15237 Amberly Dr
Tampa, FL 33647-2155
Phone
(813) 978-3636
NPI assigned
Jan 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 694415 WI
Dentist 122300000X 019028915 IL Primary

Addresses

Primary practice location

15237 Amberly Dr
Tampa, FL 33647-2155

Mailing address

15237 Amberly Dr
Tampa, FL 33647-2155
Phone (352) 585-7336

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

LicenseStateTypeSpecialty
019028915ILMDDentist
694415WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Specialists PastSince Mar 4, 2021 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": "1357084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1508102021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15237 AMBERLY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472155",
            "telephone_number": "352-585-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15237 AMBERLY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336472155",
            "telephone_number": "813-978-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARABISHY",
        "first_name": "KENAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-02",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "694415",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019028915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.