M. Tavallaei, DMD,Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48036 Issued in CA

Legal business name

M. TAVALLAEI, DMD,INC.

Practice address

2260 E Bidwell St
Suite 110
Folsom, CA 95630-3463

Phone

(916) 984-4224

Fax

(916) 984-4248

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Monica Tavallaei, D.M.D.

Title

Owner

Phone

(916) 984-4224

Specialties & licenses 1

Addresses

Other names 1

• Smile Time Dental Doing business as

Tax ID family

M Tavallaei DMD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• M. Tavallaei DMD Inc

  • General Practice Dentistry
  • Sacramento, CA
  • NPI 1700127321
  NPD tax ID
• M. Tavallaei, DMD, Inc.

  • General Practice Dentistry
  • Rocklin, CA
  • NPI 1750614541
  NPD tax ID

Locations

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1578724928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST",
            "address_2": "SUITE 301",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-984-4224",
            "fax_number": "916-984-4248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST",
            "address_2": "SUITE 110",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-984-4224",
            "fax_number": "916-984-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. TAVALLAEI, DMD,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "TAVALLAEI",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-984-4224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Time Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Breann Lymath
• Richard Clive Lynton, M.D.
• Aaron William Lyon, D.C.
• M Aggarwal MD Inc
• Shahriar Mabourakh, MD
• Mac Performance Physical Therapy Inc
• Katelyn Marie Macias
• Kaylyn Christine Macken Lynch, BACHELORS DEGREE
• Daniel Lee Maclean, MPT

• General Practice Dentistry in Folsom, CA
• Providers in Folsom, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.