NPIMap

Organization Active NPI

Emerald Coast Dental Spa

  • General Practice Dentistry
  • Panama City Beach, FL
National Provider Identifier
1548415144
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EMERALD COAST DENTAL SPA
Practice address
900 Thomas Dr
Panama City Beach, FL 32408-7442
Phone
(850) 249-9311
Fax
(850) 249-9312
NPI assigned
Nov 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Dr. Tara M Griffin, DMD PANPI 1205084704
Title
President/ Owner
Phone
(850) 249-9311

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Point of Service 305S00000X 17668 FL

Addresses

Primary practice location

900 Thomas Dr
Panama City Beach, FL 32408-7442

Mailing address

900 Thomas Dr
Panama City Beach, FL 32408-7442
Phone (850) 249-9311

Other names 1

  • Tara Walling DMD PA Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1548415144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 THOMAS DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324087442",
            "telephone_number": "850-249-9311",
            "fax_number": "850-249-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 THOMAS DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324087442",
            "telephone_number": "850-249-9311",
            "fax_number": "850-249-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD COAST DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "850-249-9311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "17668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tara Walling DMD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.