NPIMap

Organization Active NPI

Periodontal Associates of North Florida, PLLC

  • Dental Clinic/Center
  • Tallahassee, FL
National Provider Identifier
1295245181
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PERIODONTAL ASSOCIATES OF NORTH FLORIDA, PLLC
Practice address
2160 Capital Cir NE Ste 100
Tallahassee, FL 32308-4391
Phone
(850) 562-6111
Fax
(850) 562-7263
NPI assigned
Oct 4, 2017
Last updated
Oct 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Authorized official

Name
Walter E. Colon, DMD, MSNPI 1023028941
Title
President/Dentist
Phone
(850) 562-6111

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
Dental Clinic/Center 261QD0000X FL Primary

Addresses

Primary practice location

2160 Capital Cir NE Ste 100
Tallahassee, FL 32308-4391

Mailing address

2160 Capital Cir NE Ste 100
Tallahassee, FL 32308-4391
Phone (850) 562-6111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1295245181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 CAPITAL CIR NE STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084391",
            "telephone_number": "850-562-6111",
            "fax_number": "850-562-7263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 CAPITAL CIR NE STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084391",
            "telephone_number": "850-562-6111",
            "fax_number": "850-562-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES OF NORTH FLORIDA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/DENTIST",
        "authorized_official_telephone_number": "850-562-6111",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.