Tallahassee Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

TALLAHASSEE PEDIATRIC DENTISTRY

Practice address

2304 Killearn Center Blvd
Tallahassee, FL 32309-3580

Phone

(850) 666-5365

Fax

(850) 666-5365

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Shawn Hanway, DMDNPI 1740648120

Title

Owner/Pediatric Dentist

Phone

(850) 597-0573

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Shawn Hanway, DMD

  • Pediatric Dentistry
  • Tallahassee, FL
  • NPI 1740648120
  NPD (past) Authorized official
• Christin Carter Mobley

  • General Practice Dentistry
  • Tallahassee, FL
  • NPI 1649650128
  NPD (past)

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474329600000",
    "number": "1336697226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 KILLEARN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323093580",
            "telephone_number": "850-666-5365",
            "fax_number": "850-666-5365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 KILLEARN CENTER BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323093580",
            "telephone_number": "850-666-5365",
            "fax_number": "850-666-5365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A",
        "authorized_official_last_name": "HANWAY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "850-597-0573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tallahassee Orthopedic Clinic III, P.L.
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• Tallahassee Orthopedic Clinic III, P.L.
• Tallahassee Osl Operating LLC
• Tallahassee Pain Solutions LLC
• Tallahassee Pediatric Foundation, Inc.
• Tallahassee Perinatal Consultants LLC
• Tallahassee Physical Therapy & Rehabilitation Services II LLC
• Tallahassee Physical Therapy and Rehabilitation Services LLC
• Tallahassee Podiatry Associates PA

• All providers in Tallahassee, FL
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.