GD FL TLC Hollywood PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD FL TLC HOLLYWOOD PLLC

Practice address

1718 Sheridan St
Hollywood, FL 33020-2275

Phone

(954) 926-5888

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• TLC Dental Hollywood Doing business as

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1033933718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202275",
            "telephone_number": "954-926-5888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330202275",
            "telephone_number": "954-926-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD FL TLC HOLLYWOOD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLC Dental Hollywood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Gatsonis, RPH
• Susmita Gautam, PHARM.D.
• Alix Gay, MD
• Gcpa Anesthesia Services, LLC
• GD FL TLC Dental PLLC
• GDSQ Inc
• Gedeon Medical Center, MD
• Leon Stephane Gedeon, M.D.
• Tammy Lynn Gehm, LMT
• Diana Lynn Gelfand, LCSW

• General Practice Dentistry in Hollywood, FL
• Providers in Hollywood, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.