NPIMap

Organization Active NPI

St. Moses Dental LLC

Doing business as Coral Reef Dental

  • General Practice Dentistry
  • Palm Harbor, FL
National Provider Identifier
1548167984
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ST. MOSES DENTAL LLC
Doing business as
Coral Reef Dental
Practice address
3490 E Lake Rd Ste a
Palm Harbor, FL 34685-2421
Phone
(727) 789-1333
NPI assigned
Oct 20, 2026
Last updated
Oct 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

Authorized official

Name
Mina Bassaly, DMDNPI 1932805066
Title
Owner
Phone
(727) 637-5231

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3490 E Lake Rd Ste a
Palm Harbor, FL 34685-2421

Mailing address

3490 E Lake Rd Ste a
Palm Harbor, FL 34685-2421
Phone (727) 789-1333

Other names 1

  • Coral Reef Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1792454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792454400000",
    "number": "1548167984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 E LAKE RD STE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852421",
            "telephone_number": "727-789-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 E LAKE RD STE A",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852421",
            "telephone_number": "727-789-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MOSES DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-20",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A",
        "authorized_official_last_name": "BASSALY",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-637-5231",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coral Reef Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; 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.