Provider Demographics
NPI:1326509449
Name:TAYANI, ARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARIE
Middle Name:
Last Name:TAYANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 N HARBOR BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4158
Mailing Address - Country:US
Mailing Address - Phone:949-741-0795
Mailing Address - Fax:949-741-0795
Practice Address - Street 1:1460 N HARBOR BLVD STE 120
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4158
Practice Address - Country:US
Practice Address - Phone:949-741-0795
Practice Address - Fax:949-741-0793
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2022-08-24
Deactivation Date:2022-08-02
Deactivation Code:
Reactivation Date:2022-08-24
Provider Licenses
StateLicense IDTaxonomies
CA1051191223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice