Provider Demographics
NPI:1407420615
Name:TAYARI DENTAL LLC
Entity Type:Organization
Organization Name:TAYARI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LILI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-767-1200
Mailing Address - Street 1:265 WINN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-2634
Mailing Address - Country:US
Mailing Address - Phone:781-273-1152
Mailing Address - Fax:781-273-4700
Practice Address - Street 1:265 WINN ST STE 204
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2634
Practice Address - Country:US
Practice Address - Phone:781-273-1152
Practice Address - Fax:781-273-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty