NPIMap

Organization Active NPI

Tavallaei, D.M.D., Corporation

Doing business as Make a Smile

  • Pediatric Dentistry
  • Elk Grove, CA
National Provider Identifier
1922261882
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
TAVALLAEI, D.M.D., CORPORATION
Doing business as
Make a Smile
Practice address
9184 E Stockton Blvd Ste a
Elk Grove, CA 95624-9510
Phone
(916) 271-3737
NPI assigned
Jul 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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) 271-3737

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

9184 E Stockton Blvd Ste a
Elk Grove, CA 95624-9510

Mailing address

2260 E Bidwell St # 314
Folsom, CA 95630-3555
Phone (916) 271-3737

Other names 1

  • Make a Smile Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Make a Smile17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

9184 E Stockton Blvd
Ste A
Elk Grove, CA 95624
Phone (201) 835-6802

9585 Laguna Springs Dr
Ste 120
Elk Grove, CA 95758
Phone (916) 271-3737

2260 E Bidwell St
#314
Folsom, CA 95630

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1922261882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST # 314",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303555",
            "telephone_number": "916-271-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9184 E STOCKTON BLVD STE A",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249510",
            "telephone_number": "916-271-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVALLAEI, D.M.D., CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "TAVALLAEI",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-271-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Make a Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.