MRS. EVEETTE MICHELLE TAVAKKOLY (NPI# 1972709897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972709897 |
| Entity Type | Individual |
| Full Name | MRS. EVEETTE MICHELLE TAVAKKOLY |
| Credential | RDH |
| Practice Address |
647 Camino De Los Mares Ste 209 San Clemente CA 92673-2807 |
| Mailing Address |
23701 Arjay Way Laguna Niguel CA 92677-4642 |
| Practice Telephone | 9494939311 |
| Mailing Telephone | 9494251120 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | 21667 | CA | Dental Providers |
| Street Address |
647 CAMINO DE LOS MARES STE 209 |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673-2807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851559843 | Eric Scott Johnson | Dentist | 647 Camino De Los Mares Ste 209, San Clemente, CA 92673-2807 | 2008-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649568130 | Staci Billy | Dental Hygienist | 4021 Calle Abril, San Clemente, CA 92673-2603 | 2011-07-18 |
| 1760620017 | Mary Ann Mcconnell | Dental Hygienist | 14 Paseo Luna, San Clemente, CA 92673-6501 | 2009-01-24 |
| 1336542000 | Mobile Dental Cleaning | Dental Hygienist | 14 Paseo Luna, San Clemente, CA 92673-6501 | 2014-10-08 |
| 1710188776 | Christopher Reed Cook | Dental Hygienist | 647 Camino De Los Mares, Suite 209, San Clemente, CA 92673-2825 | 2007-05-29 |
| 1669692133 | Dawn Schnaidt | Dental Hygienist | 128 W El Portal, San Clemente, CA 92672-4632 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841046 | Betty Satomi Fukumoto | Dental Hygienist | 16008 S Manhattan Pl, Gardena, CA 90247-3681 | 2020-11-08 |
| 1417558180 | Maria Antonette De Lara Kim | Dental Hygienist | 66 S San Gorgonio Ave Ste 5, Banning, CA 92220-6020 | 2020-11-07 |
| 1083215982 | Sokbunntha Yan | Dental Hygienist | 5810 Fidler Ave, Lakewood, CA 90712-1251 | 2020-11-06 |
| 1649871914 | Maryam Ghahramani Shahneshin | Dental Hygienist | 1961 Grove Pl, Escondido, CA 92027-4101 | 2020-11-04 |
| 1285234047 | Maryann Detar | Dental Hygienist | 3154 Alum Rock Ave, San Jose, CA 95127-2903 | 2020-10-29 |
| 1194325597 | Connie Lim Good | Dental Hygienist | 14th Street Bldg 13128, Oceanside, CA 92055 | 2020-10-27 |
| 1336748896 | Cynthia Garcia Macdougall | Dental Hygienist | 444 Hermosa Ave Apt 302, Hermosa Beach, CA 90254-4433 | 2020-10-25 |
| 1346849163 | Ambrosia Evon Steljes | Dental Hygienist | Building 13128 14th Street, Camp Pendleton, CA 92055-5221 | 2020-10-22 |
| 1427657261 | Julie Lynn March | Dental Hygienist | 19871 Mitscher Way Bldg 2495, San Diego, CA 92145-5103 | 2020-10-22 |
| 1386243327 | Leticia Isabel Alcantar | Dental Hygienist | Bldg 520448, Camp Pendleton, CA 92055 | 2020-10-21 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
Please comment or provide details below to improve the information on MRS. EVEETTE MICHELLE TAVAKKOLY.
| 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.