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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
1700020026 | CA | Dental Providers |
Other Name | Type Code |
---|---|
Make a Smile | Doing Business As Name - Organization |
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 |
Street Address |
111 DEERWOOD RD STE 130A |
City | SAN RAMON |
State | CA |
Zip Code | 94583-4409 |
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 |
Find all providers in zip 94583 |
Taxonomy Code | 1223P0221X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Pediatric Dentistry |
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 |
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 |
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 |
Find all providers with the same taxonomy |
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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.