NPIMap

Organization Active NPI

TDC Ocean Dental, PLLC

  • Dental Clinic/Center
  • Port St Lucie, FL
National Provider Identifier
1326754128
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
TDC OCEAN DENTAL, PLLC
Practice address
491 SW Port St Lucie Blvd
Port St Lucie, FL 34953-2044
Phone
(772) 878-7525
Fax
(772) 340-1807
NPI assigned
Jan 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
Jordan Tomalty, DMD
Title
Owner
Phone
(561) 633-9676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

491 SW Port St Lucie Blvd
Port St Lucie, FL 34953-2044

Mailing address

491 SW Port St Lucie Blvd
Port St Lucie, FL 34953-2044
Phone (772) 878-7525

Other names 1

  • My Dentists of Port St Lucie Doing business as

National Provider Directory

National Provider Directory

Locations

491 SW Port St Lucie Blvd
Port St Lucie, FL 34953
Phone (772) 878-7525

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1326754128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532044",
            "telephone_number": "772-878-7525",
            "fax_number": "772-340-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 SW PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532044",
            "telephone_number": "772-878-7525",
            "fax_number": "772-340-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDC OCEAN DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "TOMALTY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-633-9676",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My Dentists of Port St Lucie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.