NPIMap

Organization Active NPI

Bopp and Tarver PLLC

  • Pediatric Dentistry
  • Lakeland, FL
National Provider Identifier
1023318052
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN5979 Issued in FL
Legal business name
BOPP AND TARVER PLLC
Practice address
1111 N Parkway Frontage Rd
Lakeland, FL 33803-0400
Phone
(863) 644-2408
Fax
(863) 646-8493
NPI assigned
Oct 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Debbie L Adrian
Title
Office Manager
Phone
(863) 644-2408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X DN5979 FL Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X DN17195 FL

Addresses

Primary practice location

1111 N Parkway Frontage Rd
Lakeland, FL 33803-0400

Mailing address

1111 N Parkway Frontage Rd
Lakeland, FL 33803-0400
Phone (863) 644-2408

Other identifiers 1

IdentifierTypeStateIssuer
076621600MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1023318052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N PARKWAY FRONTAGE RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338030400",
            "telephone_number": "863-644-2408",
            "fax_number": "863-646-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N PARKWAY FRONTAGE RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338030400",
            "telephone_number": "863-644-2408",
            "fax_number": "863-646-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOPP AND TARVER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "ADRIAN",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "863-644-2408",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN5979",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17195",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076621600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.