NPIMap

Organization Active NPI

North Tampa Dental, P.a.

  • Dentist
  • Tampa, FL
National Provider Identifier
1154700755
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN10042 Issued in FL
Legal business name
NORTH TAMPA DENTAL, P.A.
Practice address
10549 N Florida Ave
Suite E
Tampa, FL 33612-6707
Phone
(813) 935-3129
NPI assigned
May 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Dr. Ralph W Fortson, DDSNPI 1568742021
Title
President
Phone
(813) 968-1170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN10042 FL Primary

Addresses

Primary practice location

10549 N Florida Ave
Suite E
Tampa, FL 33612-6707

Mailing address

14115 Riverstone Dr
Tampa, FL 33624-6932

National Provider Directory

National Provider Directory

Locations

10549 N Florida Ave
Ste E
Tampa, FL 33612
Phone (813) 935-3129

Practitioners & affiliated clinicians

Practitioners 1

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": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1154700755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14115 RIVERSTONE DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336246932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10549 N FLORIDA AVE",
            "address_2": "SUITE E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126707",
            "telephone_number": "813-935-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TAMPA DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "FORTSON",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-968-1170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10042",
            "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 May 28, 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.