Endodontic Specialists

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

ENDODONTIC SPECIALISTS

Practice address

3670 Henderson Blvd Ste B
Tampa, FL 33609-4515

Phone

(813) 871-5900

Fax

(813) 875-7701

NPI assigned

Feb 25, 2021

Organization subpart

No

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

Authorized official

Name

Lory Selleck

Title

Practice Manager

Phone

(813) 964-8833

Specialties & licenses 1

Addresses

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yandy Gonzalez Marrero, DMD

  • Endodontics
  • Clearwater, FL
  • NPI 1265105290
  NPD (past)
• Amanda Alexis Goodman, D.D.S., M.S..

  • Endodontics
  • Tampa, FL
  • NPI 1174856751
  NPD (past)
• Robert Randal Landers, DDS

  • Endodontics
  • Tampa, FL
  • NPI 1174729602
  NPD (past)
• Kevin Bryan Melker, D.D.S., M.S.

  • Endodontics
  • Tampa, FL
  • NPI 1730225301
  NPD (past)
• Ivan Andrew Mericle, D.D.S.

  • Endodontics
  • Clearwater, FL
  • NPI 1902958069
  NPD (past)
• Michael O'Donnell, DMD

  • Endodontics
  • Brandon, FL
  • NPI 1578204145
  NPD (past)
• Kenan Tarabishy, D.D.S.

  • Dentist
  • Tampa, FL
  • NPI 1508102021
  NPD (past)
• Susan Yasrebi, DMD

  • Endodontics
  • Tampa, FL
  • NPI 1033441183
  NPD (past)

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1487248951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 EHRLICH RD STE 130",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242074",
            "telephone_number": "813-964-8833",
            "fax_number": "813-964-8883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3670 HENDERSON BLVD STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094515",
            "telephone_number": "813-871-5900",
            "fax_number": "813-875-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13135 Elk Mountain Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335797184",
            "country_code": "US",
            "telephone_number": "813-741-2777",
            "fax_number": "813-741-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2450 Sunset Point Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337651516",
            "country_code": "US",
            "telephone_number": "727-303-0600",
            "fax_number": "727-303-0601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1135 Nikki View Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335114879",
            "country_code": "US",
            "telephone_number": "813-571-7000",
            "fax_number": "813-571-7006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5111 Ehrlich Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336242074",
            "country_code": "US",
            "telephone_number": "813-964-8833",
            "fax_number": "813-964-8883",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15237 Amberly Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336472155",
            "country_code": "US",
            "telephone_number": "813-978-3636",
            "fax_number": "813-972-5430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENDODONTIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "SELLECK",
        "authorized_official_first_name": "LORY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "813-964-8833"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Tampa, FL
• Providers in Tampa, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.