Individual provider Active NPI

Adam Cheslock

  • Dentist
  • Tampa, FL
National Provider Identifier
1902214349
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN 20835 Issued in FL
Practice address
14045 N Dale Mabry Hwy
Tampa, FL 33618-2401
Phone
(813) 968-4664
NPI assigned
Jul 29, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN 20835 FL Primary

Addresses

Primary practice location

14045 N Dale Mabry Hwy
Tampa, FL 33618-2401

Mailing address

1831 N Belcher Rd
Clearwater, FL 33765-1449
Phone (727) 799-1564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160119001422 FL Order and Referring Only - DentistPractitioner - Dentist 4880997287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 20835FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1902214349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 N BELCHER RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651449",
            "telephone_number": "727-799-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14045 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182401",
            "telephone_number": "813-968-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESLOCK",
        "first_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 20835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.