Fiona M Tavakoli, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

18890 Issued in FL

Practice address

5601 Grossmont Center Dr
La Mesa, CA 91942-3074

Phone

(619) 462-2272

NPI assigned

Jun 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

State licenses

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1932410420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13478 CHELAN CT",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921294434",
            "telephone_number": "904-859-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423074",
            "telephone_number": "619-462-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAKOLI",
        "first_name": "FIONA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "18890",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63528",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Arthur Tansey, PH.D.
• Dayana Tapia, LMFT
• Dan B Tarango, DPM
• Salvatore Tarantino, M.D.
• Robin L. Tarbox-Roland, L.M.F.T. 28766
• Johanna Sanai Tavarez Valdivia
• John Howard Taylor, MD
• Kenya Lashey Taylor, LMFT
• Rojhane Taylor
• Elizabeth A Tecca, NP

• Dentist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.