Active NPI
Matthew Munro
- General Practice Dentistry
- Tampa, FL
National Provider Identifier
1174182091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN24190
- Practice address
- 12030 Anderson Rd
Tampa, FL 33625-5682 - Phone
- (813) 381-5646
- Fax
- (813) 425-2773
- NPI assigned
- Jun 13, 2019
- Sex
- Male
- 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 | DN24190 | FL | Primary |
Addresses
Primary practice location
12030 Anderson Rd
Tampa, FL 33625-5682
Mailing address
12030 Anderson Rd
Tampa, FL 33625-5682
Phone (813) 381-5646
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN24190 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1174182091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12030 ANDERSON RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336255682",
"telephone_number": "813-381-5646",
"fax_number": "813-425-2773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12030 ANDERSON RD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336255682",
"telephone_number": "813-381-5646",
"fax_number": "813-425-2773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNRO",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN24190",
"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 Jun 13, 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.