Talisha H Cunningham, D.M.D.

Individual provider Active NPI General Practice Dentistry · Starke, FL

NPI 1386880896 · NPPES record last updated Jan 5, 2009

Key facts

NPI
1386880896
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN15127 (FL)
Practice address
459 W Call St
Starke, FL 32091-3115
Phone
(904) 964-5152
Fax
(904) 964-9557
NPI assigned
Jan 5, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN15127FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
NLD #4 - Starke PLLC Past
since Nov 3, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN15127 FL Yes

Addresses

Primary practice location

459 W Call St
Starke, FL 32091-3115

Mailing address

459 W Call St
Starke, FL 32091-3115
Phone (904) 964-5152

Other providers in Starke, FL

All providers in Starke, FL · General Practice Dentistry in Florida

Sources for this page

Verify at the official NPI Registry.