Active NPI
Richard Hamilton Waldbart, D.M.D.
- General Practice Dentistry
- Tampa, FL
National Provider Identifier
1871702407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4775
- Practice address
- 4208 W Bay to Bay Blvd
Tampa, FL 33629-6608 - Phone
- (813) 837-3476
- NPI assigned
- May 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4775 | FL | Primary |
Addresses
Primary practice location
4208 W Bay to Bay Blvd
Tampa, FL 33629-6608
Mailing address
4627 W Leona St
Tampa, FL 33629-7645
Phone (813) 839-1347
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4775 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871702407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4627 W LEONA ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336297645",
"telephone_number": "813-839-1347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 W BAY TO BAY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336296608",
"telephone_number": "813-837-3476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDBART",
"first_name": "RICHARD",
"middle_name": "HAMILTON",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "4775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.