Andrew Dale Poulson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN23720 Issued in FL

Practice address

10555 Bloomingdale Ridge Dr
Riverview, FL 33578-4455

Phone

(813) 252-2273

Fax

(813) 904-5182

NPI assigned

May 28, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vallo Riverview, PLLC

  • General Practice Dentistry
  • Riverview, FL
  • NPI 1598529687
  NPD

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1235541004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 BLOOMINGDALE RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784455",
            "telephone_number": "813-252-2273",
            "fax_number": "813-904-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 BLOOMINGDALE RIDGE DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784455",
            "telephone_number": "813-252-2273",
            "fax_number": "813-904-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULSON",
        "first_name": "ANDREW",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-28",
        "last_updated": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039906",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronda Porter, PH. D., LMFT
• Joseph Leon Portnoy, MD
• Positive Transformations PA
• Damon Potter, PHARMD
• Steven Mark Pouls, DO
• Nigel G Poulton, LMHC
• Bridgett Corin Powe, OT
• Antwanique Powell
• Cheryl Powell, ACNPC-AG
• John Gregory Powell, RRT

• Dentist in Riverview, FL
• Providers in Riverview, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.