Active NPI
Coast Dental P.a.
Doing business as Coast Dental-Tallahassee
- Dentist
- Tallahassee, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- COAST DENTAL P.A.
- Doing business as
- Coast Dental-Tallahassee
- Practice address
- 1329 Mahan Dr
Tallahassee, FL 32308-5107 - Phone
- (850) 878-7999
- Fax
- (850) 942-2681
- NPI assigned
- May 27, 2021
- Last updated
- May 27, 2021
- Organization subpart
- Yes
- Parent organization
- COAST DENTAL P.A.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melody Rivera
- Title
- Credentialing Manager
- Phone
- (813) 350-7166
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | NU | Primary |
Addresses
Primary practice location
1329 Mahan Dr
Tallahassee, FL 32308-5107
Mailing address
5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262
Phone (813) 288-1999
Other names 1
- Coast Dental-Tallahassee
National Provider Directory
National Provider Directory- Tax ID family
- Coast Dental PA
- Part of
- Coast Dental PA
Other organizations with this tax ID 31
Organizations that report the same tax identification number in the National Provider Directory.
Locations
1329 Mahan Dr
Tallahassee, FL 32308
Phone (850) 878-7999
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Dentist
- Tampa, FL
- NPI 1992803860
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Dental Hygienist
- Tallahassee, FL
- NPI 1508462573
-
- Dental Hygienist
- Tallahassee, FL
- NPI 1861096810
-
- Dentist
- Crawfordville, FL
- NPI 1619661303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622073600000",
"number": "1316513666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5706 BENJAMIN CENTER DR STE 103",
"city": "TAMPA",
"state": "FL",
"postal_code": "336345262",
"telephone_number": "813-288-1999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 MAHAN DR",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085107",
"telephone_number": "850-878-7999",
"fax_number": "850-942-2681"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COAST DENTAL P.A.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COAST DENTAL P.A.",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A",
"authorized_official_last_name": "RIVERA",
"authorized_official_first_name": "MELODY",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "813-350-7166"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Coast Dental-Tallahassee",
"code": "3",
"type": "Doing Business As"
}
]
}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 May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.