St. Luke's Dental, PLC.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN15339 Issued in FL

Legal business name

ST. LUKE'S DENTAL, PLC.

Practice address

1908 Land O Lakes Blvd
Suite 3
Lutz, FL 33549-2914

Phone

(813) 909-1555

Fax

(813) 909-1556

NPI assigned

Sep 26, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Wahba, DDS

Title

Owner

Phone

(813) 909-1555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1588091250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 LAND O LAKES BLVD",
            "address_2": "SUITE 3",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492914",
            "telephone_number": "813-909-1555",
            "fax_number": "813-909-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 LAND O LAKES BLVD",
            "address_2": "SUITE 3",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492914",
            "telephone_number": "813-909-1555",
            "fax_number": "813-909-1556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S DENTAL, PLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "WAHBA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-909-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN15339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SRS Healthcare PLLC
• St Joseph's Diagnostic Center LLC (BayCare Outpatient Imaging)
• St Josephs Hopsital
• St Lukes Surgical Center Inc (St. Luke's Surgical at Wesley Chapel)
• St. Joseph's Hospital, Inc.
• Michelle St.John
• Nicole Stanina, LCSW
• Toni-Ann Stansell
• Cheyenne Blue Starczewski, LMHC
• Brooke Starr, AGACNP-BC

• Dental Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.