Tarpon Shores Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TARPON SHORES DENTAL, LLC

Practice address

544 John Ringling Blvd
Sarasota, FL 34236-1430

Phone

(941) 388-4114

NPI assigned

Jan 5, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Chandeev Romesh Weerasooriya, DMD

Title

Manager

Phone

(941) 474-9548

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1357344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479772800000",
    "number": "1447597802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E VENICE AVE",
            "address_2": "SUITE F",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342857160",
            "telephone_number": "941-488-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 JOHN RINGLING BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342361430",
            "telephone_number": "941-388-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARPON SHORES DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-05",
        "last_updated": "2016-11-22",
        "status": "A",
        "authorized_official_last_name": "WEERASOORIYA",
        "authorized_official_first_name": "CHANDEEV",
        "authorized_official_middle_name": "ROMESH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "941-474-9548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CCN",
            "identifier": "511613837863",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Renee Tarawally, CAA
• Ahmed Mahmoud Salem Tarbay, MEDICAL DOCTOR
• Amanda Tarbell
• Tarpon Opco LLC
• Tarpon Point FL Opco LLC
• Marina Taskovska
• Tamora Taubig, AP, DOM
• Staci Taviloglu, LCSW
• Jana Taylor-Long
• Aimee B Taylor, MSN, APRN, FNP-BC

• General Practice Dentistry in Sarasota, FL
• Providers in Sarasota, FL by specialty
• General Practice Dentistry in Florida

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