TDC Port St.Lucie LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TDC PORT ST.LUCIE LLC

Practice address

1385 SW Gatlin Blvd
Port St Lucie, FL 34953-4102

Phone

(561) 777-8980

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Jordan Tomalty, DMD

Title

Owner/Dentist

Phone

(561) 777-8980

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1952832313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 SW GATLIN BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 SW GATLIN BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534102",
            "telephone_number": "561-777-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TDC PORT ST.LUCIE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "TOMALTY",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "561-777-8980",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regan Marquis Taylor
• Velma Joyce Taylor
• TC Physicians LLC
• TDC Ocean Dental, PLLC
• TDC Port St. Lucie LLC
• Teach Skills & Empower, LLC
• Julie Teigen, APRN
• Jennifer Corona Teitelbaum
• Martin D Tejada, LCSW
• Mirnophta Telusma

• Dental Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.