NPIMap

Organization Active NPI

Ddsdmd, LLC

  • General Practice Dentistry
  • Tallahassee, FL
National Provider Identifier
1700145349
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN17786 Issued in FL
Legal business name
DDSDMD, LLC
Practice address
2621 Mitcham Dr
Suite #102
Tallahassee, FL 32308-5480
Phone
(850) 425-1300
Fax
(850) 219-1527
NPI assigned
May 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Authorized official

Name
Dr. Richard Jean-Pierre Bastien, D.M.D.NPI 1770782039
Title
Owner
Phone
(850) 566-2972

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN17786 FL Primary

Addresses

Primary practice location

2621 Mitcham Dr
Suite #102
Tallahassee, FL 32308-5480

Mailing address

5716 Farnsworth Dr
Tallahassee, FL 32312-4881
Phone (850) 566-2972

Other identifiers 2

IdentifierTypeStateIssuer
1619274529OtherFLNPPES
1770782039OtherFLNPPES

Other names 1

  • Bastien Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

2621 Mitcham Dr
Ste 102
Tallahassee, FL 32308
Phone (850) 425-1300

Practitioners & affiliated clinicians

Practitioners 3

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": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1700145349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 FARNSWORTH DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323124881",
            "telephone_number": "850-566-2972",
            "fax_number": "850-219-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 MITCHAM DR",
            "address_2": "SUITE #102",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085480",
            "telephone_number": "850-425-1300",
            "fax_number": "850-219-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDSDMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "BASTIEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JEAN-PIERRE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-566-2972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1619274529",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1770782039",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bastien Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.