Provider Demographics
NPI:1205958915
Name:TADROS, TAREK NABIL (DDS)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:NABIL
Last Name:TADROS
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 1:9906 VALERIO CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-5928
Mailing Address - Country:US
Mailing Address - Phone:909-633-8917
Mailing Address - Fax:661-392-1956
Practice Address - Street 1:4698 AMERICAN AVE
Practice Address - Street 2:SUITE # B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4007
Practice Address - Country:US
Practice Address - Phone:661-834-5660
Practice Address - Fax:661-834-0518
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA459851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice