Alexander Bradley Tabatabai

Primary specialty

DentistTaxonomy code 122300000X

License

41972 Issued in TX

Practice address

204 W 19TH St
Mount Pleasant, TX 75455-2320

Phone

(903) 572-4141

NPI assigned

Apr 2, 2025

Reactivated

Sep 19, 2025

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Shahid Dental Group Mt. Pleasant, PLLC

  • Dental Clinic/Center
  • Mt Pleasant, TX
  • NPI 1992395420
  NPD
• Taylor Beach Club

  • Dentist
  • Mt Pleasant, TX
  • NPI 1720499189
  NPD (past)

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1891599486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W 19TH ST",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552320",
            "telephone_number": "214-645-3979",
            "fax_number": "214-648-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W 19TH ST",
            "city": "MOUNT PLEASANT",
            "state": "TX",
            "postal_code": "754552320",
            "telephone_number": "903-572-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABATABAI",
        "first_name": "ALEXANDER",
        "middle_name": "BRADLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "deactivation_date": "2025-09-05",
        "reactivation_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "41972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul D. Stone, PHARM.D., R.PH.
• Victoria Lee Stretcher, SLP
• Roger G Stuart Jr., M.D.
• Dongxu Sun, M.D.
• Susan Branham
• Asma Tahir
• Taylor Beach Club
• Garry Bill Taylor, D.O.
• Stephanie Judith Taylor, FNP
• Texarkana Eye Associates

• Dentist in Mount Pleasant, TX
• Providers in Mount Pleasant, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.