Steve D Taborda

Primary specialty

DentistTaxonomy code 122300000X

License

DN19830 Issued in FL

Practice address

3751 South Clyde Morris Blvd
Unit 7
Port Orange, FL 32129-2356

Phone

(386) 267-4718

Fax

(386) 265-1486

NPI assigned

Jul 5, 2012

Last updated

Feb 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Smiles Kingdom Inc

  • Dentist
  • Port Orange, FL
  • NPI 1407215965
  NPD (past) Authorized official

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1528323581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291609",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321291609",
            "telephone_number": "386-267-4718",
            "fax_number": "386-265-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 SOUTH CLYDE MORRIS BLVD",
            "address_2": "UNIT 7",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292356",
            "telephone_number": "386-267-4718",
            "fax_number": "386-265-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABORDA",
        "first_name": "STEVE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-05",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Swift
• Emily Symons
• Jillian Szakal
• Jeffry A Szymczak, RPH
• Dillon Tabar
• Angela Marie Tague, L.M.T.
• Sandra Tai
• Tallahassee Orthopedic Clinic III, P.L.
• Guan-Ju Tao
• Peter M Tassent, MPT

• Dentist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.