Individual provider Active NPI

Dallen Mason Strong

  • General Practice Dentistry
  • Pensacola, FL
National Provider Identifier
1043883978
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2021020125 Issued in MO
Practice address
3101 W Michigan Ave Ste F
Pensacola, FL 32526-1876
Phone
(850) 944-5515
NPI assigned
Jul 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2021020125 MO Primary

Addresses

Primary practice location

3101 W Michigan Ave Ste F
Pensacola, FL 32526-1876

Mailing address

140 S Ranchos Legante Dr
Gilbert, AZ 85296-2066

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
2021020125MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1043883978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S RANCHOS LEGANTE DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W MICHIGAN AVE STE F",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325261876",
            "telephone_number": "850-944-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRONG",
        "first_name": "DALLEN",
        "middle_name": "MASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2021020125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.