TAVALLAEI, D.M.D., CORPORATION


Address: 111 Deerwood Rd Ste 130a, San Ramon, CA 94583-4409
Phone: 9254024141

TAVALLAEI, D.M.D., CORPORATION (NPI# 1386159879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386159879
Entity Type Organization
Organization Name TAVALLAEI, D.M.D., CORPORATION
Other Organization Name MAKE A SMILE
Practice Address 111 Deerwood Rd Ste 130a
San Ramon
CA 94583-4409
Mailing Address 2260 E Bidwell St Ste 310
Folsom
CA 95630-3555
Practice Telephone 9254024141
Practice Fax Number 9169839012
Enumeration Date 2017-12-06
Last Update Date 2017-12-06
Authorized Official Name MEGAN CASTILLO (OPERATIONS MANAGER)
Authorized Official Telephone 9167816550
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0221X Dentist
Specialization: Pediatric Dentistry
1700020026 CA Dental Providers

Other Provider/Organization Names

Other Name Type Code
Make a Smile Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1508349606 Tavallaei, D.m.d., Corporation Dentist 6406 Sunrise Blvd Ste A, Citrus Heights, CA 95610-5992 2018-09-13
1740795657 Tavallaei, D.m.d., Corporation Dentist 1955 W Texas St Ste 2a, Fairfield, CA 94533-4462 2017-12-14
1922261882 Tavallaei, D.m.d., Corporation Dentist 9585 Laguna Springs Dr, Suite 120, Elk Grove, CA 95758-7969 2008-07-09
1538225933 Tavallaei, D.m.d., Corporation Dentist 500 Auburn Folsom Rd, Suite330, Auburn, CA 95603 2006-12-29
1538225503 Tavallaei, D.m.d., Corporation Dentist 2190 E. Bidwell St., Folsom, CA 95630 2006-12-28
1194107748 Tavallaei, D.m.d., Corporation Dentist 7227 29th St, Sacramento, CA 95822-5005 2015-06-19
1992008098 Tavallaei, D.m.d., Corporation Dentist 3433 Arden Way, Sacramento, CA 95825-2018 2010-12-10
1871752915 Tavallaei, D.m.d., Corporation Dentist 2241 Sunset Blvd, Suite D, Rocklin, CA 95765-4295 2008-06-04
1184780587 Tavallaei, D.m.d., Corporation Dentist 3840 El Dorado Hills Blvd, Suite 203, El Dorado Hills, CA 95762-4567 2006-12-29

Office Location

Street Address 111 DEERWOOD RD STE 130A
City SAN RAMON
State CA
Zip Code 94583-4409

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1295375475 Angel Beatrice Mckneely Behavior Technician 3150 Crow Canyon Place, Suite 110, San Ramon, CA 94583 2020-01-15
1205302247 Asma Parisa Rezaye Behavior Technician 4708 Norris Canyon Rd, Unit 201, San Ramon, CA 94583 2018-10-17
1679055461 Mary Martineau Speech-Language Pathologist 210 Porter Dr Ste 120, San Ramon, CA 94583 2018-08-29
1336631332 Alison Jean Barnes Behavior Technician Goals for Autism, 1 Crow Canyon Court, San Ramon, CA 94583 2018-06-05
1730671975 Michael Federico Pharmacist 2735 Ascot Drive, San Ramon, CA 94583 2018-06-04
1508384843 Donor Network West Organ Procurement Organization 12667 Alcosta Blvd., Suite 500, San Ramon, CA 94583 2017-09-07
1265950141 Danielle Lustig Fitch Marriage & Family Therapist 3180 Crown Canyon Pl. Ste 140, San Ramon, CA 94583 2017-08-31
1386166205 Park Place Ambulatory Surgery Center Orthopaedic Surgery 100 Park Place, Suite 100, San Ramon, CA 94583 2017-07-12
1952822991 Virginia Rutledge Mosby Marriage & Family Therapist 3180 Crow Canyon Place #140, San Ramon, CA 94583 2017-06-29
1437684784 Nakhla Dental Group Dentist Crow Canyon Dental, 2821 Crow Canyon Road #200, San Ramon, CA 94583 2017-04-25
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Taxonomy Information

Taxonomy Code 1223P0221X
Grouping Dental Providers
Classification Dentist
Specialization Pediatric Dentistry

Taxonomy Definition

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174160501 Roya Mahmoodi Dds, Inc Dentist 1501 Bollinger Canyon Rd Ste B, San Ramon, CA 94583-1758 2019-12-04
1104037761 Mahmoud H Ashrafi Dentist 1501 Bollinger Canyon Road, #b, San Ramon, CA 94583 2007-05-25
1598773129 Christine Rimi Kobayashi Dentist 2301 Camino Ramon, Suite 284, San Ramon, CA 94583-4440 2006-08-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1790385227 Johnson Ann Wong Dental Corporation Dentist 6512 N Figueroa St Ste 3, Los Angeles, CA 90042-2155 2020-10-26
1205440211 Jessica Choi, Dmd, Dental Corporation Dentist 2318 Huntington Dr, San Marino, CA 91108-2641 2020-09-08
1659985802 Rw Fattouch Dmd, Inc. Dentist 42210 Lyndie Ln Ste 100, Temecula, CA 92591-3604 2020-09-04
1174136998 Armand Begian Dds Inc. Dentist 4021 Mission Oaks Blvd # 180, Camarillo, CA 93012-5156 2020-08-31
1164035473 Armand Begian Dds Inc. Dentist 3687 Las Posas Rd Ste 180, Camarillo, CA 93010-1431 2020-08-26
1518577972 Michael Vincent Laureola Dds Inc Dentist 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 2020-07-31
1396360384 Drs Salem and Soliman Dental Corp Dentist 2119 E Hatch Rd Ste Bandc, Modesto, CA 95351-4814 2020-06-15
1689299471 Abhishek Batra Dentist 11052 Evans St, Loma Linda, CA 92354-2709 2020-06-08
1194348060 Bryan Chao Dentist 1895 Mowry Ave Ste 121, Fremont, CA 94538-1736 2020-05-26
1255953618 Mohammad Abul-fielat Dds Inc Dentist 3825 Tyler St, Riverside, CA 92503 2020-05-08
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Competitor

Search similar providers

City SAN RAMON
Zip Code 94583

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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