NPIMap

Organization Active NPI

Tavallaei, D.M.D., Corporation

  • Pediatric Dentistry
  • Sacramento, CA
National Provider Identifier
1992008098
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
48036 Issued in CA
Legal business name
TAVALLAEI, D.M.D., CORPORATION
Doing business as
Make a Smile
Practice address
3433 Arden Way
Sacramento, CA 95825-2018
Phone
(916) 374-7711
NPI assigned
Dec 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Monica Tavallaei, D.M.D.
Title
Owner
Phone
(916) 374-7711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 48036 CA Primary

Addresses

Primary practice location

3433 Arden Way
Sacramento, CA 95825-2018

Mailing address

3433 Arden Way
Sacramento, CA 95825-2018

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

3433 Arden Way
Sacramento, CA 95825
Phone (404) 513-7189

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1992008098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 ARDEN WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 ARDEN WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958252018",
            "telephone_number": "916-374-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAVALLAEI, D.M.D., CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-10",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "TAVALLAEI",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-374-7711",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "48036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Make a Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.