Organization Active NPI

Tally Dental, PA

  • General Practice Dentistry
  • Tallahassee, FL
National Provider Identifier
1487285276
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TALLY DENTAL, PA
Practice address
2418 Millcreek LN # 3
Tallahassee, FL 32308-4368
Phone
(850) 727-5773
NPI assigned
Jan 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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

Authorized official

Name
Dr. Romelio R Abreu, DMDNPI 1568639268
Title
Dentist
Phone
(850) 727-5773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2418 Millcreek LN # 3
Tallahassee, FL 32308-4368

Mailing address

3425 Bannerman Rd Ste 105-138
Tallahassee, FL 32312-7062
Phone (850) 727-5773

Other identifiers 2

IdentifierTypeStateIssuer
105466300MedicaidFL
112219500MedicaidFL

National Provider Directory

National Provider Directory

Locations

3425 Bannerman Rd
Ste 105138
Tallahassee, FL 32312

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1487285276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 BANNERMAN RD STE 105-138",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323127062",
            "telephone_number": "850-727-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2418 MILLCREEK LN # 3",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084368",
            "telephone_number": "850-727-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "ABREU",
        "authorized_official_first_name": "ROMELIO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "850-727-5773",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105466300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112219500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.