Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

TARA TAVAKOLIAN DMD
NPI 1972410603
Dentist in Fort Campbell, KY

Q: What is Tara Tavakolian's NPI number?

The NPI number for Tara Tavakolian is 1972410603. It was assigned to this individual provider in the NPPES registry on August 26, 2026.

Q: What is Tara Tavakolian's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Tara Tavakolian was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 days 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.

Active since August 26, 2026

5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223(888) 217-4563 Get Directions Write a Review

NPPES record added: August 26, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Tara Tavakolian Dmd NPPES

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

TARA TAVAKOLIAN DMD (NPI 1972410603) is an individual dentist in Fort Campbell, Kentucky, licensed in Utah (143039059926) and active in the NPI registry since August 2026.

NPPES Registry Identity

NPI1972410603

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameTARA TAVAKOLIANCredential: DMD

Location Address5979 DESERT STORM AVEFort Campbell, KY 42223

Mailing Address1500 Dalton Smith Court, 212Clarksville, TN 37043 · (571) 344-1223

Phone(888) 217-4563

Sole ProprietorNo

Enumeration DateAugust 26, 2026

NPPES CertifiedAugust 26, 2026

✔ NPI 1972410603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in UT · 143039059926

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

5979 DESERT STORM AVE, Fort Campbell, KY 42223

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DUKE PHU NGUYEN DMD

Dentist (General Practice)