PERIODONTAL ASSOCIATES OF TAMPA BAY, P.A. (NPI# 1053606178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053606178 |
| Entity Type | Organization |
| Organization Name | PERIODONTAL ASSOCIATES OF TAMPA BAY, P.A. |
| Practice Address |
5208 E Fowler Ave Ste F Temple Terrace FL 33617-2152 |
| Practice Telephone | 8139881103 |
| Practice Fax Number | 8139851524 |
| Mailing Telephone | 8139881103 |
| Mailing Fax Number | 8139851524 |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |
| Authorized Official Name | DR. BRIAN TODD VANAELST (PERIODONTIST) |
| Authorized Official Telephone | 8139881103 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN16867 | FL | Dental Providers |
| Street Address |
5208 E FOWLER AVE STE F |
| City | TEMPLE TERRACE |
| State | FL |
| Zip Code | 33617-2152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285253195 | Kare Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 7860 North 56th Street, Tampa, FL 33617 | 2020-04-10 |
| 1942840467 | Care Medrx LLC | Pharmacy | 311 Bullard Pkwy Ste. B, Temple Terrace, FL 33617 | 2020-01-13 |
| 1467004804 | Favorite Care Services, LLC | In Home Supportive Care | 7628 N 56th St Ste 2, Tampa, FL 33617 | 2019-07-16 |
| 1982265625 | Promise Home Care Agency LLC | In Home Supportive Care | 315 Bahamas Ave, Tampa, FL 33617 | 2019-06-24 |
| 1164912754 | Superior Physician Group | Pain Medicine | 10730 N 56th St Ste 209, Temple Terrace, FL 33617 | 2018-05-18 |
| 1346738796 | Advanced Pain Management and Anesthesiology | Clinic/Center | 4209 E. Busch Blvd, Tampa, FL 33617 | 2018-05-01 |
| 1184112427 | Imperial Connections Support Programs, LLC | In Home Supportive Care | 9806 N Connechusett Rd, Tampa, FL 33617 | 2018-04-23 |
| 1609394204 | Erin E Sleeper | Behavior Technician | 418 Belle Claire Ave, Temple Terrace, FL 33617 | 2017-09-03 |
| 1720504293 | Robin A Kelly | Nurse's Aide | 7523 Pitch Pine Circle, Apt B, Tampa, FL 33617 | 2017-08-16 |
| 1174046023 | Rishita Amish Patel | Pharmacist | 532 Heritage Brook Cir, Apt #101, Temple Terrace, FL 33617 | 2017-07-24 |
| Find all providers in zip 33617 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508039660 | Norman Chad Bardsley | Dentist | 8851 N 56th St, Temple Terrace, FL 33617-6203 | 2008-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344354 | Philipkjosephsllc | Dentist | 161 Monterey Bay Dr, Boynton Beach, FL 33426-8438 | 2020-10-21 |
| 1194322651 | Peter Tsambazis Dmd, Inc | Dentist | 6654 Collier Blvd Unit 104, Naples, FL 34114-8179 | 2020-10-07 |
| 1265041578 | Lauren Elise Steinberg | Dentist | 7301 W Palmetto Park Rd Ste 303a, Boca Raton, FL 33433-3458 | 2020-07-23 |
| 1306462213 | Miami Healthy Smiles | Dentist | 8861 Sw 69th Ct, Pinecrest, FL 33156-1605 | 2020-06-17 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1437785847 | Modern Dental Cape Coral Pllc | Dentist | 706 Sw Pine Island Rd, Suite 103, Cape Coral, FL 33991 | 2020-03-17 |
| 1437783792 | Anthony Joseph Michelotti | Dentist | 3331 Briarwood Cir, Safety Harbor, FL 34695-4691 | 2020-02-26 |
| 1417595893 | Park Plaza Dental Care | Dentist | 1144 N Federal Hwy, Pompano Beach, FL 33062-4322 | 2019-12-16 |
| 1619538832 | George Edward Tolson V | Dentist | 1739 E Commercial Blvd, Oakland Park, FL 33334-5737 | 2019-06-27 |
| 1396203485 | Michael Steven Liss | Dentist | 2600 N Military Trl Ste 310, Boca Raton, FL 33431-6315 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | TEMPLE TERRACE |
| Zip Code | 33617 |
Please comment or provide details below to improve the information on PERIODONTAL ASSOCIATES OF TAMPA BAY, P.A..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.