Provider Demographics
NPI:1659517530
Name:TATARI, FADI (DDS)
Entity Type:Individual
Prefix:DR
First Name:FADI
Middle Name:
Last Name:TATARI
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 1:2300 MCCUE RD APT 262
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4638
Mailing Address - Country:US
Mailing Address - Phone:281-701-4666
Mailing Address - Fax:713-552-0496
Practice Address - Street 1:2300 MCCUE RD APT 262
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-4638
Practice Address - Country:US
Practice Address - Phone:281-701-4666
Practice Address - Fax:713-552-0496
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19937122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist