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TAVALLAEI DMD CORP
NPI 1407690811
Clinic/Center - Dental in Stockton, CA

Active since June 20, 2024
5756 PACIFIC AVE STE 75A, STOCKTON, CA 95207(916) 984-0304 Get Directions Write a Review

NPPES record last updated: June 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tavallaei Dmd Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAVALLAEI DMD CORP (NPI 1407690811), doing business as Make A Smile, is a healthcare organization registered as a dental in Stockton, California and active in the NPI registry since June 2024. The organization lists Megan Castillo, Admin, as its authorized official.

NPPES Registry Identity

NPI1407690811
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameTAVALLAEI DMD CORP
Location Address5756 PACIFIC AVE STE 75AStockton, CA 95207-5156
Mailing Address400 Plaza Dr # 120-319Folsom, CA 95630-4744
Phone(916) 984-0304
Organization SubpartNo
Authorized OfficialMegan CastilloAdmin · (916) 781-6550
Enumeration DateJune 20, 2024
NPPES CertifiedJune 20, 2024
✔ NPI 1407690811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
5756 PACIFIC AVE STE 75A, Stockton, CA 95207
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Other Names 1

Doing Business AsMake A Smile

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tavallaei Dmd Corp's NPI number?

The NPI number for Tavallaei Dmd Corp is 1407690811. It was assigned to this organization in the NPPES registry on June 20, 2024. The provider is doing business as Make a Smile.

Where is Tavallaei Dmd Corp located?

Tavallaei Dmd Corp is located at 5756 Pacific Ave Ste 75A, Stockton, CA 95207. The listed phone number is (916) 984-0304.

What is Tavallaei Dmd Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Tavallaei Dmd Corp was last updated on June 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.