Hendrick B. Tafo-Tabue, DDS, PC

Primary specialty

DentistTaxonomy code 122300000X

License

0401413401 Issued in VA

Legal business name

HENDRICK B. TAFO-TABUE, DDS, PC

Practice address

12201 Tiverton LN
Glen Allen, VA 23059-7015

Phone

(832) 713-2497

NPI assigned

Aug 25, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Hendrick Bastiaan Tafo-Tabue, DDS

Title

Owner

Phone

(832) 713-2497

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408924800000",
    "number": "1922408194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 TIVERTON LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597015",
            "telephone_number": "832-713-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 TIVERTON LN",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230597015",
            "telephone_number": "832-713-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICK B. TAFO-TABUE, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-08-25",
        "status": "A",
        "authorized_official_last_name": "TAFO-TABUE",
        "authorized_official_first_name": "HENDRICK",
        "authorized_official_middle_name": "BASTIAAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-713-2497",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.