Erik J Tallbacka, D.M.D.,F.A.G.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14116 Issued in FL

Practice address

309 SE Osceola St
Suite # 102
Stuart, FL 34994-2251

Phone

(772) 287-4530

Fax

(772) 287-9787

NPI assigned

Jul 19, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1043410913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 SE OSCEOLA ST",
            "address_2": "SUITE # 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942251",
            "telephone_number": "772-287-4530",
            "fax_number": "772-287-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 SE OSCEOLA ST",
            "address_2": "SUITE # 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942251",
            "telephone_number": "772-287-4530",
            "fax_number": "772-287-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLBACKA",
        "first_name": "ERIK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,F.A.G.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "14116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Taillefer
• Yuki Takahashi
• Maylin Henderson Talbot
• Alisha Anne Talford
• Talgood Enterprises II, LLC
• Ashley Colleen Talledo
• Mary Linda Tallent
• Amanda Tallentire
• Roderick Talley
• Leighan H Talton, D.O.

• General Practice Dentistry in Stuart, FL
• Providers in Stuart, 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 Jul 19, 2007; 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.