NPIMap

Organization Active NPI

TDC Boca Raton, LLC

  • Dentist
  • Boca Raton, FL
National Provider Identifier
1053960419
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
TDC BOCA RATON, LLC
Practice address
9878 Clint Moore Rd Ste 200
Boca Raton, FL 33496-1037
Phone
(561) 852-7773
Fax
(561) 483-5737
NPI assigned
Sep 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Authorized official

Name
Dr. Sean Tomalty, DMD
Title
Owner
Phone
(561) 777-8980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

9878 Clint Moore Rd Ste 200
Boca Raton, FL 33496-1037

Mailing address

8794 W Boynton Beach Blvd Ste 110
Boynton Beach, FL 33472-4468
Phone (561) 777-8980

Other names 1

  • Boca Raton Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

9878 Clint Moore Rd
Ste 200
Boca Raton, FL 33496
Phone (561) 852-7773

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1053960419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8794 W BOYNTON BEACH BLVD STE 110",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334724468",
            "telephone_number": "561-777-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9878 CLINT MOORE RD STE 200",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334961037",
            "telephone_number": "561-852-7773",
            "fax_number": "561-483-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDC BOCA RATON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "TOMALTY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-777-8980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boca Raton Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.