NPIMap

Organization Active NPI

Apd - Tacachale

  • Dentist
  • Gainesville, FL
National Provider Identifier
1275771560
Registry record updated Mar 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN8807 Issued in FL
Legal business name
APD - TACACHALE
Practice address
1621 NE Waldo Rd
Gainesville, FL 32609-3900
Phone
(352) 955-5616
NPI assigned
Jan 26, 2009
Last updated
Mar 26, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2009

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

Authorized official

Name
Mr. Don E Thomas
Title
Superintendent
Phone
(352) 955-5856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN8807 FL Primary

Addresses

Primary practice location

1621 NE Waldo Rd
Gainesville, FL 32609-3900

Mailing address

1621 NE Waldo Rd
Gainesville, FL 32609-3900
Phone (352) 955-5668

Other identifiers 1

IdentifierTypeStateIssuer
681084596MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Agency for Persons With Disabilities12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1275771560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 NE WALDO RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093900",
            "telephone_number": "352-955-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 NE WALDO RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093900",
            "telephone_number": "352-955-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APD - TACACHALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SUPERINTENDENT",
        "authorized_official_telephone_number": "352-955-5856",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN8807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "681084596",
            "state": "FL"
        }
    ],
    "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 Mar 26, 2009; 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.