TAVALLAEI, D.M.D., CORPORATION (NPI# 1871752915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871752915 |
Entity Type | Organization |
Organization Name | TAVALLAEI, D.M.D., CORPORATION |
Other Organization Name | MAKE A SMILE |
Practice Address |
2241 Sunset Blvd Suite D Rocklin CA 95765-4295 |
Practice Telephone | 9163800102 |
Practice Fax Number | 9169839012 |
Mailing Telephone | 9163800102 |
Mailing Fax Number | 9169839012 |
Enumeration Date | 2008-06-04 |
Last Update Date | 2016-04-12 |
Authorized Official Name | DR. MONICA TAVALLAEI (PEDIATRIC DENTIST) |
Authorized Official Telephone | 9163800102 |
Authorized Official Credential | DMD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
48036 | 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 |
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 |
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 |
2241 SUNSET BLVD SUITE D |
City | ROCKLIN |
State | CA |
Zip Code | 95765-4295 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871591552 | Kenneth Andrew Kloos | Physical Therapist | 2241 Sunset Blvd, Suite A, Rocklin, CA 95765-4230 | 2005-07-07 |
1942690516 | S. Jang Dds Incorporated | Dentist | 2241 Sunset Blvd, # E, Rocklin, CA 95765-4295 | 2015-02-03 |
1013307719 | S.y. Jang Dds Corporatiom | Dentist | 2241 Sunset Blvd, # D, Rocklin, CA 95765-4295 | 2015-02-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427537760 | Kristine Reymont | Case Manager/Care Coordinator | 2717 Fleet Circle, Rocklin, CA 95765 | 2018-08-08 |
1275063877 | Alicia Marie Yost-cardoza | Registered Nurse | 6459 Cormorant Cir, Rocklin, CA 95765 | 2017-06-15 |
1457769457 | Jacob Dean Kelly | Dentist | 5800 Stanford Ranch Rd Ste 900, Rocklin, CA 95765 | 2014-07-23 |
1124438270 | Denise L. Buchholz | Physical Therapist | 1924 Mckinley St, Rocklin, CA 95765 | 2014-04-29 |
1205198926 | Gay Lee Wilhelm | Registered Nurse | 5508 Rye Court, Rocklin, CA 95765 | 2012-06-08 |
1407147341 | Michael Knutson | Dentist | 6518 Lonetree Blvd # 1061, Rocklin, CA 95765 | 2011-04-26 |
1184922924 | Stephen S Taft V | Counselor | 6520 Lonetree Blvd # 120, Rocklin, CA 95765 | 2011-03-03 |
1326245143 | Susan Kathleen Smith | Counselor | 5402 Sandpiper Ct., Rocklin, CA 95765 | 2007-06-27 |
1790986057 | Rebound Rehab Physical Therapy, Inc. | Physical Therapist | 6526 Lonetree Blvd, Rocklin, CA 95765 | 2007-05-31 |
1184838351 | Darce Aaron Slate | Dentist | 6512 Lonetree Blvd., Suite # 100, Rocklin, CA 95765 | 2007-05-09 |
Find all providers in zip 95765 |
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 |
---|---|---|---|---|
1184632697 | Dennis Roy Peterson | Dentist | 5420 Park Dr, Rocklin, CA 95765 | 2006-08-03 |
1295261600 | Rocklin Kids Dentist | Dentist | 5420 Park Dr, Rocklin, CA 95765-5562 | 2017-05-04 |
1013307719 | S.y. Jang Dds Corporatiom | Dentist | 2241 Sunset Blvd, # D, Rocklin, CA 95765-4295 | 2015-02-02 |
1588925911 | Jessica Alt | Dentist | 2221 Sunset Blvd, Ste 101, Rocklin, CA 95765-4784 | 2012-06-01 |
1558389775 | Barry Macdonald | Dentist | 5410 Park Dr, Rocklin, CA 95765-5562 | 2006-07-17 |
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.