Organization Active NPI

Boland & Mannari LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • St Petersburg, FL
National Provider Identifier
1760783468
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
ME50633 Issued in FL
Legal business name
BOLAND & MANNARI LLC
Practice address
6540 4TH St N
Suite a
St Petersburg, FL 33702-6822
Phone
(727) 525-0155
Fax
(727) 525-0155
NPI assigned
Nov 11, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Authorized official

Name
Thomas J Boland, MD, DMD
Title
Physician
Phone
(727) 525-0155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X ME50633 FL Primary

Addresses

Primary practice location

6540 4TH St N
Suite a
St Petersburg, FL 33702-6822

Mailing address

6540 4TH St N
Suite a
St Petersburg, FL 33702-6822
Phone (727) 525-0155

National Provider Directory

National Provider Directory

Locations

6540 4th St N
Ste A
St Petersburg, FL 33702
Phone (727) 525-0155

Practitioners & affiliated clinicians

Practitioners 2

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": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1760783468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6540 4TH ST N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337026822",
            "telephone_number": "727-525-0155",
            "fax_number": "727-525-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6540 4TH ST N",
            "address_2": "SUITE A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337026822",
            "telephone_number": "727-525-0155",
            "fax_number": "727-525-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLAND & MANNARI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "BOLAND",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "727-525-0155",
        "authorized_official_credential": "MD, DMD"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "ME50633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.