Individual provider Active NPI

Bryan D Tallman, DMD

  • Dentist
  • Pinellas Park, FL
National Provider Identifier
1942333729
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN15878 Issued in FL
Practice address
7000 66TH Street N
Pinellas Park, FL 33781-4067
Phone
(727) 546-4665
Fax
(727) 446-8382
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN15878 FL Primary

Addresses

Primary practice location

7000 66TH Street N
Pinellas Park, FL 33781-4067

Mailing address

2189 Cleveland St
Suite 252
Clearwater, FL 33765-3243
Phone (727) 461-9149

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
I20160307002294 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709182447

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN15878FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
FL Dental Centers PLLC Dentist PastSince Sep 11, 2022 Accepting new patients
Florida Dental Centers Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1942333729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 CLEVELAND ST",
            "address_2": "SUITE 252",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653243",
            "telephone_number": "727-461-9149",
            "fax_number": "727-446-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 66TH STREET N",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337814067",
            "telephone_number": "727-546-4665",
            "fax_number": "727-446-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLMAN",
        "first_name": "BRYAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

Verify at the official NPI Registry.