Individual provider Active NPI

Ashlee P Goodman-Tabari, DMD

  • General Practice Dentistry
  • Glen Allen, VA
National Provider Identifier
1730529967
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0101414670 Issued in VA
Practice address
10220 Staples Mill Rd
Glen Allen, VA 23060-3064
Phone
(804) 767-2507
Fax
(804) 767-2571
NPI assigned
Jul 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0101414670 VA Primary

Addresses

Primary practice location

10220 Staples Mill Rd
Glen Allen, VA 23060-3064

Mailing address

10220 Staples Mill Rd
Glen Allen, VA 23060-3064
Phone (804) 767-2507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170123000325 MD Order and Referring Only - DentistPractitioner - Dentist 1557681715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0101414670VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
A-Z Sleep & Airway Center PLLC Current Accepting new patients

Locations

10220 Staples Mill Rd
Glen Allen, VA 23060
Phone (804) 767-2507

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1730529967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 STAPLES MILL RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603064",
            "telephone_number": "804-767-2507",
            "fax_number": "804-767-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 STAPLES MILL RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603064",
            "telephone_number": "804-767-2507",
            "fax_number": "804-767-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN-TABARI",
        "first_name": "ASHLEE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0101414670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.