TAVALLAEI, D.M.D., CORPORATION (NPI# 1740795657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740795657 |
| Entity Type | Organization |
| Organization Name | TAVALLAEI, D.M.D., CORPORATION |
| Practice Address |
1955 W Texas St Ste 2a Fairfield CA 94533-4462 |
| Mailing Address |
2260 E Bidwell St # 311 Folsom CA 95630-3555 |
| Practice Telephone | 9167077973 |
| Mailing Telephone | 9167816550 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-15 |
| Authorized Official Name | MEGAN CASTILLO (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 |
48036 | CA | Dental Providers |
| 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 |
| 1386159879 | Tavallaei, D.m.d., Corporation | Dentist | 111 Deerwood Rd Ste 130a, San Ramon, CA 94583-4409 | 2017-12-06 |
| 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 |
1955 W TEXAS ST STE 2A |
| City | FAIRFIELD |
| State | CA |
| Zip Code | 94533-4462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487347 | Shayondelice Sledge | Case Manager/Care Coordinator | 3001 N. Texas St., #27, Fairfield, CA 94533 | 2020-08-16 |
| 1508401191 | Tiffany Ann Garcia | Social Worker | 1301 Roman Way, Martinez, CA 94533 | 2019-11-07 |
| 1609424175 | Andrew Stephens | Student in an Organized Health Care Education/Training Program | Dgmc, 101 Bodin Cir, Fairfield, CA 94533 | 2019-08-28 |
| 1821645383 | Michelle Marie Hackett | Marriage & Family Therapist | 1745 Enterprise Dr., Bldg. 2, Ste 1a, Fairfield, CA 94533 | 2019-08-20 |
| 1780154369 | Maria Leonila Ramos Corpuz | Behavior Technician | 744 Empire Street Suite 160, Fairfield, CA 94533 | 2018-11-27 |
| 1629575303 | Jeanne Ann Kiernan | Dentist | 690 Airman Dr, Apo, AA 94533 | 2018-04-10 |
| 1629596820 | Max Kardos | Student in an Organized Health Care Education/Training Program | 801 Empire St., Fairfield, CA 94533 | 2017-09-07 |
| 1780119867 | Justin Denhart Dickson | Student in an Organized Health Care Education/Training Program | 101 Bodin Cir Fairfield Ca 94533, David Grant Medical Center, Fpo, AA 94533 | 2017-04-26 |
| 1639613409 | Behrooz Shafiezadeh | Marriage & Family Therapist | Caminar, 601 Madison Street, Suite D, Fairfield, CA 94533 | 2016-12-13 |
| 1427500164 | Tanya Ayers | Counselor | 801 Empire Street, Fairfield, CA 94533 | 2016-10-28 |
| Find all providers in zip 94533 | ||||
| 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 |
|---|---|---|---|---|
| 1396006110 | Adam Shaffer | Dentist | 3694 Hilborn Rd Ste 100, Fairfield, CA 94534-7994 | 2012-06-07 |
| 1326255373 | Kids First Pediatric Dentistry & Orthodontics | Dentist | 1478 Post Rd., Fairfield, CT 06824-5938 | 2007-05-17 |
| 1831211721 | Gregory Mokotoff | Dentist | 1478 Post Rd, Fairfield, CT 06824-5938 | 2007-04-04 |
| 1821175514 | Mark Choi | Dentist | 2500 N Texas St, Suite C, Fairfield, CA 94533-1639 | 2006-11-01 |
| 1568552909 | Irma Lucia Garcia | Dentist | 3694 Hilborn Road, Fairfield, CA 94534 | 2006-10-14 |
| 1558311951 | Richard W. Kennedy | Dentist | 1246 Nilles Rd, Suite 3, Fairfield, OH 45014-2912 | 2006-05-10 |
| 1013514140 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Dentist | 3694 Hilborn Rd Ste 100, Fairfield, CA 94534-7994 | 2020-10-01 |
| 1902374739 | Adams Shaffer Dds Inc | Dentist | 3694 Hilborn Rd Ste 100, Fairfield, CA 94534-7994 | 2018-11-09 |
| 1386009884 | Dennis Paul Nutter Dds, Inc | Dentist | 3694 Hilborn Rd Ste 100, Fairfield, CA 94534-7994 | 2015-12-28 |
| 1205215837 | Kristan Joi Ingraham | Dentist | 1478 Post Rd, Fairfield, CT 06824-5938 | 2015-05-28 |
| Find all providers in FAIRFIELD | ||||
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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.