TAVAKOLIAN DDS INC. NPI 1104552231

NPI Information

  • NPI: 1104552231
  • Provider Name: TAVAKOLIAN DDS, INC.
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 2041 PIONEER CT STE 100
    SAN MATEO, CA
    ZIP 94403
  • Phone: (240) 750-9239

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NPI Details

TAVAKOLIAN DDS, INC. is a dental clinic center in San Mateo, CA. TAVAKOLIAN DDS, INC. NPI is 1104552231. The provider is registered as an organization entity type.

The provider's business location address is:

2041 PIONEER CT STE 100
SAN MATEO, CA
ZIP 94403-729
Phone: (240) 750-9239

The provider's authorized official is Pardis Tavakolian .
The authorized official title is President and has the following contact phone number (240) 750-9239.

The enumeration date for this NPI number is 7/30/2022 and was last updated on 11/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11932656949OTHERCALIFORNIANPI TYPE 1

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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