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General NPI Number Information
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NPI Number | 1912759911
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Entity Type | Individual
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Provider Name | PEYMAN TADI DDS
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Gender | Male
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Dates
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Enumeration Date | 04/03/2024
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Last Update Date | 06/29/2025
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Provider Practice Location Address
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Address Line | 3364 SOUTHWESTERN BLVD
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1524
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Country | US
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Telephone | 716-332-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 6386 TRANSIT RD APT 549
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City | DEPEW
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State | NY
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Zip | 14043-1127
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Country | US
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Telephone | 716-566-8182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 064664
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License Number State | NY
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