Tyrone Square Mall Dental P.a

Primary specialty

DentistTaxonomy code 122300000X

License

DN16377 Issued in FL

Legal business name

TYRONE SQUARE MALL DENTAL P.A

Practice address

6747 Tyrone SQ
St Petersburg, FL 33710-3934

Phone

(954) 846-7171

Fax

(954) 846-7170

NPI assigned

May 16, 2014

Organization subpart

No

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

Authorized official

Name

Rostislav Krasnov, DENTIST

Title

DDS

Phone

(954) 846-7171

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1487065058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6747 TYRONE SQ",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103934",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6747 TYRONE SQ",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337103934",
            "telephone_number": "954-846-7171",
            "fax_number": "954-846-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYRONE SQUARE MALL DENTAL P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "KRASNOV",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "954-846-7171",
        "authorized_official_credential": "DENTIST"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN16377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaney Tyl
• Michael Robert Tyler, RPH
• Rose Hanna Tyler
• Timara Tyler, LCDC, LMHC
• Tyrone Manor
• George Tyson, M.D.
• Heather M Tyson, APRN
• U S Lab & Radiology LLC
• U.S. Healthworks Meddical Group of Florida, Inc.
• U.S. Healthworks Meddical Group of Florida, Inc.

• Dentist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.