Individual provider Active NPI

Thomas Michael Sedlak Sr., DDS

  • General Practice Dentistry
  • Inverness, FL
National Provider Identifier
1629476338
Registry record updated Dec 11, 2014
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN11363 Issued in FL
Practice address
3288 E Thomas St
Inverness, FL 34453-3212
Phone
(352) 344-3448
NPI assigned
Dec 11, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN11363 FL Primary

Addresses

Primary practice location

3288 E Thomas St
Inverness, FL 34453-3212

Mailing address

3288 E Thomas St
Inverness, FL 34453-3212
Phone (352) 344-3448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151111001756 FL Order and Referring Only - DentistPractitioner - Dentist 2466762067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN11363FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas M. Sedlak, P.a. General Practice Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1629476338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3288 E THOMAS ST",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533212",
            "telephone_number": "352-344-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3288 E THOMAS ST",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533212",
            "telephone_number": "352-344-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLAK",
        "first_name": "THOMAS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.