Individual provider Active NPI

Dana Tarabishy, DMD

  • Dentist
  • Brandon, FL
National Provider Identifier
1437772415
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN25574 Issued in FL
Practice address
165 E Bloomingdale Ave
Brandon, FL 33511-8102
Phone
(813) 643-6969
Fax
(813) 643-6556
NPI assigned
May 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1858802 MA
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DN25574 FL Primary

Addresses

Primary practice location

165 E Bloomingdale Ave
Brandon, FL 33511-8102

Mailing address

25049 Lambrusco Loop
Lutz, FL 33559-1807
Phone (352) 442-9633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221201000738 FL Order and Referring Only - DentistPractitioner - Dentist 5991173502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN25574FLMDDentist
DN1858802MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Dental P.a. Dentist CurrentSince Jun 2, 2024 Accepting new patients
Coast Dental P.a. Dentist PastSince Jun 2, 2024 Accepting new patients
Dental Dreams LLC PastSince Sep 1, 2020 Accepting new patients

Locations

165 E Bloomingdale Ave
Brandon, FL 33511
Phone (813) 643-6969

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1437772415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25049 LAMBRUSCO LOOP",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335591807",
            "telephone_number": "352-442-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118102",
            "telephone_number": "813-643-6969",
            "fax_number": "813-643-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARABISHY",
        "first_name": "DANA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-25",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1858802",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.