NPIMap

Organization Active NPI

Pediatric Dentistry of New Tampa

  • Pediatric Dentistry
  • Tampa, FL
National Provider Identifier
1891128773
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN14483 Issued in FL
Legal business name
PEDIATRIC DENTISTRY OF NEW TAMPA
Practice address
5326 Primrose Lake Cir
Tampa, FL 33647-3589
Phone
(813) 374-0388
Fax
(813) 374-0390
NPI assigned
Aug 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Authorized official

Name
Dr. Marta Milagros Rivera, D.M.D.NPI 1972601920
Title
President/Owner
Phone
(813) 374-0388

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X DN14483 FL Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X DN19520 FL

Addresses

Primary practice location

5326 Primrose Lake Cir
Tampa, FL 33647-3589

Mailing address

5326 Primrose Lake Cir
Tampa, FL 33647-3589
Phone (813) 374-0388

National Provider Directory

National Provider Directory

Locations

5326 Primrose Lake Cir
Tampa, FL 33647
Phone (813) 374-0388

Practitioners & affiliated clinicians

Practitioners 1

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": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1891128773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5326 PRIMROSE LAKE CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473589",
            "telephone_number": "813-374-0388",
            "fax_number": "813-374-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5326 PRIMROSE LAKE CIR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336473589",
            "telephone_number": "813-374-0388",
            "fax_number": "813-374-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF NEW TAMPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARTA",
        "authorized_official_middle_name": "MILAGROS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "813-374-0388",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN14483",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN19520",
            "primary": false
        }
    ],
    "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 Aug 15, 2013; 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.