TDC Canyon LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TDC CANYON LLC

Practice address

8794 W Boynton Beach Blvd
Suite 110
Boynton Beach, FL 33472-4468

Phone

(561) 777-8980

Fax

(561) 777-8608

NPI assigned

Dec 2, 2015

Organization subpart

No

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

Authorized official

Name

Sean Tomalty, DMD

Title

Dentist/Owner

Phone

(561) 777-8980

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1053786038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8794 W BOYNTON BEACH BLVD",
            "address_2": "SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724468",
            "telephone_number": "561-777-8980",
            "fax_number": "561-777-8608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8794 W BOYNTON BEACH BLVD",
            "address_2": "SUITE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724468",
            "telephone_number": "561-777-8980",
            "fax_number": "561-777-8608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDC CANYON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "TOMALTY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "561-777-8980",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.

Verify at the official NPI Registry.