Provider Demographics
NPI:1013464197
Name:TATARI DENTAL ASSOCIATES PLLC
Entity Type:Organization
Organization Name:TATARI DENTAL ASSOCIATES PLLC
Other - Org Name:NOVA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:TATARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-288-4090
Mailing Address - Street 1:6915 ANTOINE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77091-1214
Mailing Address - Country:US
Mailing Address - Phone:281-741-7400
Mailing Address - Fax:281-741-7400
Practice Address - Street 1:6915 ANTOINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-1214
Practice Address - Country:US
Practice Address - Phone:281-741-7400
Practice Address - Fax:281-741-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty