Individual
KEYVAN TAVAKOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
18964 N DALE MABRY HWY STE 103, LUTZ, FL 33548-4913
(813) 591-1568
Mailing address
18964 N DALE MABRY HWY STE 103, LUTZ, FL 33548-4913
(813) 591-1568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
056001
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
100032
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
10615
NC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22487
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
32856
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056001
—
NY
Enumeration date
10/16/2012
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us