Sadie Ann Tallbacka, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN30508 Issued in FL

Practice address

6820 Matthews Mint Hill Rd Ste 204
Mint Hill, NC 28227-9492

Phone

(704) 800-0255

NPI assigned

May 20, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1760274146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2337 SW ARCHER RD APT 3030",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081018",
            "telephone_number": "772-485-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 MATTHEWS MINT HILL RD STE 204",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279492",
            "telephone_number": "704-800-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLBACKA",
        "first_name": "SADIE",
        "middle_name": "ANN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN30508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Sullivan, DDS
• Kenisha Best Sullivan, RN
• Farrah Swinton
• Tabonuco Counseling and Consulting PLLC
• Tall Family Services, Inc.
• Margaret Ann Telfer, LCMHC
• Michelle Jean Terry
• Asmerom A Tesfazion
• The Shaw Estates, LLP
• Karen H Thomas, LPC

• General Practice Dentistry in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.