Active NPI
Tasneem Koleilat, MS, DMD
- General Practice Dentistry
- Gainesville, FL
National Provider Identifier
1053972620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24120
- Practice address
- 13718 NW 30TH Rd
Gainesville, FL 32606-9325 - Phone
- (701) 426-0099
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24120 | FL | Primary |
Addresses
Primary practice location
13718 NW 30TH Rd
Gainesville, FL 32606-9325
Mailing address
13718 NW 30TH Rd
Gainesville, FL 32606-9325
Phone (701) 426-0099
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24120 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561420800000",
"number": "1053972620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13718 NW 30TH RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326069325",
"telephone_number": "701-426-0099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13718 NW 30TH RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326069325",
"telephone_number": "701-426-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLEILAT",
"first_name": "TASNEEM",
"credential": "MS, DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-25",
"last_updated": "2019-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "24120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.