Larry Tabatchnick, DMD, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8750 Issued in NC

Practice address

2409 Robeson St
Fayetteville, NC 28305-5549

Phone

(910) 483-9546

Fax

(910) 483-8550

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

Yes

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 NC

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

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• East Carolina University

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• East Carolina University

  • Dentist
  • Greenville, NC
  • NPI 1669750014
  NPD
• Manchester Oral Surgery, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Manchester, NH
  • NPI 1467062935
  NPD (past)
• North Manchester Oral and Maxillofacial Surgery, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Manchester, NH
  • NPI 1417114687
  NPD (past)

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1821085465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-483-9546",
            "fax_number": "910-483-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055549",
            "telephone_number": "910-483-9546",
            "fax_number": "910-483-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABATCHNICK",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "8750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T & S Homeplace
• T&C& Associates Home Care Agencey
• T&C&Associates Home Care
• T&S Homeplace
• T&W Chiropractic Services, Inc.
• Dana Tabb
• Tabi Tabe-Ebob, M.D.
• Tactical Rehabilitation, Inc.
• Taft'S Creative Service Council, Inc.
• Alain Bruno Tagne Nouemssi, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Oral and Maxillofacial Surgery (Dentist) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.