Individual provider Active NPI

Adam Diasti

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1033229562
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN12490 Issued in FL
Practice address
2307 S Dale Mabry Hwy
Suite C
Tampa, FL 33629-6322
Phone
(813) 254-6838
NPI assigned
Aug 30, 2006
Last updated
Jun 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN12490 FL Primary
General Practice Dentistry 1223G0001X DS0000007478 TN
General Practice Dentistry 1223G0001X 0401102418 VA
General Practice Dentistry 1223G0001X DN011634 GA

Addresses

Primary practice location

2307 S Dale Mabry Hwy
Suite C
Tampa, FL 33629-6322

Mailing address

4010 W Boy Scout Blvd
Suite 1100-Credentialing
Tampa, FL 33607-5727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN12490FLMDGeneral Practice Dentistry
DN011634GAMDGeneral Practice Dentistry
DS0000007478TNMDGeneral Practice Dentistry
0401102418VAMDGeneral Practice Dentistry

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1033229562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 W BOY SCOUT BLVD",
            "address_2": "SUITE 1100-CREDENTIALING",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 S DALE MABRY HWY",
            "address_2": "SUITE C",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336296322",
            "telephone_number": "813-254-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIASTI",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN12490",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000007478",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401102418",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011634",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.