NPIMap

Organization Active NPI

McIlwain Dental Specialists

  • Pediatric Dentistry
  • Tampa, FL
National Provider Identifier
1386648863
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
14465 Issued in FL
Legal business name
MCILWAIN DENTAL SPECIALISTS
Practice address
4710 N Habana Ave
Ste 203
Tampa, FL 33614-7146
Phone
(813) 879-8097
Fax
(813) 875-8792
NPI assigned
Jun 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Dr. Leigh Ann McIlwain, DMDNPI 1417295072
Title
Owner
Phone
(813) 879-8097

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
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 14465 FL Primary

Addresses

Primary practice location

4710 N Habana Ave
Ste 203
Tampa, FL 33614-7146

Mailing address

4710 N Habana Ave
Ste 203
Tampa, FL 33614-7146
Phone (813) 879-8097

National Provider Directory

National Provider Directory

Locations

4710 N Habana Ave
Ste 203
Tampa, FL 33614
Phone (813) 879-8097

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": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1386648863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE",
            "address_2": "STE 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147146",
            "telephone_number": "813-879-8097",
            "fax_number": "813-875-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE",
            "address_2": "STE 203",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147146",
            "telephone_number": "813-879-8097",
            "fax_number": "813-875-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCILWAIN DENTAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "MCILWAIN",
        "authorized_official_first_name": "LEIGH ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-879-8097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "14465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.