Active NPI
Dorothy Theogene, DDS
- Pediatric Dentistry
- Tampa, FL
National Provider Identifier
1699055004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- HAD47
- Practice address
- 7814 N Dale Mabry Hwy
Tampa, FL 33614-3220 - Phone
- (813) 405-3939
- Fax
- (813) 405-3938
- NPI assigned
- Aug 17, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | HAD47 | FL | Primary |
Addresses
Primary practice location
7814 N Dale Mabry Hwy
Tampa, FL 33614-3220
Mailing address
PO Box 82969
Tampa, FL 33682-2969
Phone (813) 866-0930
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151102002889 | FL | Order and Referring Only - Dentist | 5991015042 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Class Kids Pediatric Dentistry PLLC | Pediatric Dentistry | Current | 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.
-
- Pediatric Dentistry
- Brandon, FL
- NPI 1619833159
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443139200000",
"number": "1699055004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 82969",
"city": "TAMPA",
"state": "FL",
"postal_code": "336822969",
"telephone_number": "813-866-0930",
"fax_number": "813-866-0929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7814 N DALE MABRY HWY",
"city": "TAMPA",
"state": "FL",
"postal_code": "336143220",
"telephone_number": "813-405-3939",
"fax_number": "813-405-3938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEOGENE",
"first_name": "DOROTHY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-17",
"last_updated": "2015-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "HAD47",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
- Camille Suzanne Thelin, M.D.
- Janeen M Theobald, ARNP
- Robert James Theobald III, DO
- Theodore Edward David Peters, DDS,PA
- Margaret Theodore, M.D.
- Christine Theophilopoulos, CRNA
- Therakids Plus Center for Children & Adults
- Theramed Place LLC
- Theranova Counseling, LLC
- Therapeds Physical Therapy Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.