Tania Tahsili Fahadan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107157 Issued in CA

Practice address

3851 Katella Ave Ste 225
Los Alamitos, CA 90720-3353

Phone

(562) 285-6767

NPI assigned

Dec 14, 2021

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1699434985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W COMMONWEALTH AVE APT 217",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928323720",
            "telephone_number": "310-717-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 KATELLA AVE STE 225",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203353",
            "telephone_number": "562-285-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHSILI FAHADAN",
        "first_name": "TANIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T.H. Choi, a Medical Corp.
• T.H. Choi, a Medical Corporation
• Michael P. Tabibian, M.D.
• Mohan V. Tadikonda, M.D.
• Shahram Taheri, MD
• Betty C Tai, PHARMD
• Patrick Taitingfong
• Talbert Anesthesia Group Incorporated
• Darryl Tad Tanaka, OTR/L
• Hank K. Tang, MD

• General Practice Dentistry in Los Alamitos, CA
• Providers in Los Alamitos, 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 Dec 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.