Organization Active NPI

Periorage PLLC

  • Periodontics
  • Tampa, FL
National Provider Identifier
1962186056
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
PERIORAGE PLLC
Practice address
4450 E Fletcher Ave Ste B
Tampa, FL 33613-4907
Phone
(813) 468-8882
NPI assigned
Jun 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Authorized official

Name
Dr. Wayne Kuo, DDSNPI 1801939418
Title
President
Phone
(813) 468-8882

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

4450 E Fletcher Ave Ste B
Tampa, FL 33613-4907

Mailing address

4450 E Fletcher Ave Ste B
Tampa, FL 33613-4907
Phone (813) 468-8882

National Provider Directory

National Provider Directory

Locations

4450 E Fletcher Ave
Ste B
Tampa, FL 33613
Phone (813) 468-8882

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": "1686268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686268800000",
    "number": "1962186056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 E FLETCHER AVE STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134907",
            "telephone_number": "813-468-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 E FLETCHER AVE STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336134907",
            "telephone_number": "813-468-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIORAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A",
        "authorized_official_last_name": "KUO",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-468-8882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jun 9, 2023; 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.