NPIMap

Organization Active NPI

Community Dental Services

  • Dentist
  • Tampa, FL
National Provider Identifier
1750656716
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN10929 Issued in FL
Legal business name
COMMUNITY DENTAL SERVICES
Practice address
4010 W State St
Tampa, FL 33609-1264
Phone
(813) 793-7032
Fax
(813) 441-1986
NPI assigned
Mar 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Edith Kavouklis
Title
President
Phone
(813) 793-7032

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN10929 FL Primary

Addresses

Primary practice location

4010 W State St
Tampa, FL 33609-1264

Mailing address

4010 W State St
Tampa, FL 33609-1264
Phone (813) 793-7032

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1750656716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-793-7032",
            "fax_number": "813-441-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091264",
            "telephone_number": "813-793-7032",
            "fax_number": "813-441-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "KAVOUKLIS",
        "authorized_official_first_name": "EDITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-793-7032"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.