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TALLAHASSEE PEDIATRIC DENTISTRY NPI 1336697226


NPI Information

NPI: 1336697226
Provider Name: TALLAHASSEE PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

CLIA Number: 10D1092283

Address:
2304 KILLEARN CENTER BLVD
TALLAHASSEE, FL
ZIP 32309
Phone: (850) 666-5365
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TALLAHASSEE PEDIATRIC DENTISTRY is a pediatric dentistry dentist in Tallahassee, FL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. TALLAHASSEE PEDIATRIC DENTISTRY NPI is 1336697226. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2304 KILLEARN CENTER BLVD
TALLAHASSEE, FL
ZIP 32309-580
Phone: (850) 666-5365
Fax: (850) 666-5365

The provider's authorized official is Shawn Hanway .
The authorized official title is Owner/pediatric Dentist and has the following contact phone number (850) 597-0573.

The CLIA number assigned to this NPI record is 10D1092283 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/20/2016 and was last updated on 9/20/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric DentistryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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