Active NPI
Timberlane Family Dentistry
- General Practice Dentistry
- Lecanto, FL
National Provider Identifier
1043600604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 593246519
- Legal business name
- TIMBERLANE FAMILY DENTISTRY
- Practice address
- 1972 N Future Ter
Lecanto, FL 34461-9341 - Phone
- (352) 746-9111
- Fax
- (352) 746-7180
- NPI assigned
- Feb 3, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Miss Missy Darlene Degolyer
- Title
- Reception
- Phone
- (352) 746-9111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 593246519 | FL | Primary |
Addresses
Primary practice location
1972 N Future Ter
Lecanto, FL 34461-9341
Mailing address
1972 N Future Ter
Lecanto, FL 34461-9341
Phone (352) 746-9111
National Provider Directory
National Provider DirectoryLocations
1972 N Future Ter
Lecanto, FL 34461
Phone (352) 746-9111
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Lecanto, FL
- NPI 1336349703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1422921600000",
"number": "1043600604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1972 N FUTURE TER",
"city": "LECANTO",
"state": "FL",
"postal_code": "344619341",
"telephone_number": "352-746-9111",
"fax_number": "352-746-7180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1972 N FUTURE TER",
"city": "LECANTO",
"state": "FL",
"postal_code": "344619341",
"telephone_number": "352-746-9111",
"fax_number": "352-746-7180"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMBERLANE FAMILY DENTISTRY",
"organizational_subpart": "NO",
"enumeration_date": "2015-02-03",
"last_updated": "2015-02-03",
"status": "A",
"authorized_official_last_name": "DEGOLYER",
"authorized_official_first_name": "MISSY",
"authorized_official_middle_name": "DARLENE",
"authorized_official_title_or_position": "RECEPTION",
"authorized_official_telephone_number": "352-746-9111",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "593246519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lecanto, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.