NPIMap

Organization Active NPI

Dental Specialty Group of Tampa Bay PLLC

  • Dentist
  • Pinellas Park, FL
National Provider Identifier
1720596067
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DENTAL SPECIALTY GROUP OF TAMPA BAY PLLC
Practice address
4326 Park Blvd N Ste C-East
Pinellas Park, FL 33781-3555
Phone
(727) 544-5345
Fax
(727) 547-8263
NPI assigned
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Ruben Fernando Mesia, DDS, MSNPI 1245499334
Title
Owner/Periodontist
Phone
(352) 222-7512

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4326 Park Blvd N Ste C-East
Pinellas Park, FL 33781-3555

Mailing address

4326 Park Blvd N Ste C-East
Pinellas Park, FL 33781-3555
Phone (727) 544-5345

National Provider Directory

National Provider Directory

Locations

4326 Park Blvd N
Ste E
Pinellas Park, FL 33781
Phone (727) 544-5345

Practitioners & affiliated clinicians

Practitioners 4

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": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1720596067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4326 PARK BLVD N STE C-EAST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813555",
            "telephone_number": "727-544-5345",
            "fax_number": "727-547-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4326 PARK BLVD N STE C-EAST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337813555",
            "telephone_number": "727-544-5345",
            "fax_number": "727-547-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALTY GROUP OF TAMPA BAY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "MESIA",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_middle_name": "FERNANDO",
        "authorized_official_title_or_position": "OWNER/PERIODONTIST",
        "authorized_official_telephone_number": "352-222-7512",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.