Provider Demographics
NPI:1780836635
Name:DR. TAMIMI & ASSOCIATES (EASTON), INC.
Entity Type:Organization
Organization Name:DR. TAMIMI & ASSOCIATES (EASTON), INC.
Other - Org Name:DENTALWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIS/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:S
Authorized Official - Last Name:EL-TAMIMI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:614-476-8780
Mailing Address - Street 1:PO BOX 860036
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486
Mailing Address - Country:US
Mailing Address - Phone:216-584-1000
Mailing Address - Fax:216-332-7503
Practice Address - Street 1:3727 EASTON MARKET
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219
Practice Address - Country:US
Practice Address - Phone:614-476-8780
Practice Address - Fax:216-584-1026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTALONE PARTNERS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-22
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
122300000X, 1223P0221X, 1223P0300X, 1223P0700X, 1223X0400X
OH30.0219211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty