Individual provider Active NPI

Andrew Michael Vallo, D.D.S

  • General Practice Dentistry
  • Tampa, FL
National Provider Identifier
1114379500
Registry record updated Mar 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN24420 Issued in FL
Practice address
10909 W Linebaugh Ave Ste 100
Tampa, FL 33626-1741
Phone
(813) 536-7766
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3024737 OH
General Practice Dentistry 1223G0001X DN24420 FL Primary

Addresses

Primary practice location

10909 W Linebaugh Ave Ste 100
Tampa, FL 33626-1741

Mailing address

12425 Seabrook Dr
Tampa, FL 33626-2432
Phone (412) 389-0977

Other practice location 1

600 W 3rd St
Mansfield, OH 44906-2633
Phone (419) 522-6191

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3024737OHMDDentist
DN24420FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740873600000",
    "number": "1114379500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 SEABROOK DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262432",
            "telephone_number": "412-389-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 W LINEBAUGH AVE STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261741",
            "telephone_number": "813-536-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449062633",
            "country_code": "US",
            "telephone_number": "419-522-6191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLO",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2025-03-02",
        "certification_date": "2025-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "3024737",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2025; 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.