NORTHEAST DENTAL CARE (NPI# 1619065356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619065356 |
| Entity Type | Organization |
| Organization Name | NORTHEAST DENTAL CARE |
| Practice Address |
13905 Bruce B Downs Blvd Suite A Tampa FL 33613-3905 |
| Practice Telephone | 8139781090 |
| Mailing Telephone | 8139781090 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ROBERT OVERTON BERSOT (OWNER) |
| Authorized Official Telephone | 8139781090 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 10448 | FL | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | NORTHEAST DENTAL CARE P.C. | 405 Lexington Ave., 6906, New York, New York 10174 |
| Street Address |
13905 BRUCE B DOWNS BLVD SUITE A |
| City | TAMPA |
| State | FL |
| Zip Code | 33613-3905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215923016 | Cecil Constantine Aird | Surgery | 13905 Bruce B Downs Blvd, Ste. B, Tampa, FL 33613-3905 | 2005-09-27 |
| 1932230141 | Tampa Bay Hand Surgery Center, P.a. | Clinic/Center | 13905 Bruce B Downs Blvd, Suite B, Tampa, FL 33613-3998 | 2007-03-08 |
| 1134250384 | Tampa Bay Hand Center, P.a. | Surgery | 13905 Bruce B Downs Blvd, Suite B, Tampa, FL 33613-3998 | 2007-03-08 |
| 1003904715 | Robert Overton Bersot | Dentist | 13905 Bruce B Downs Blvd, Suite A, Tampa, FL 33613-3905 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467079491 | Matthew Devivo | Dentist | 112 N 12th St Unit 2115, Tampa, FL 33602-3762 | 2020-06-25 |
| 1760034144 | Cody Alan Neill | Dentist | 14936 N Florida Ave Ste 101, Tampa, FL 33613-1641 | 2019-07-15 |
| 1457903866 | Sanket Ashvinbhai Rathod | Dentist | 2560 Brown Noddy Ln Apt 406, Tampa, FL 33619-4324 | 2019-07-15 |
| 1609432400 | Virginia Mckenzie Melmed | Dentist | 120 Barbados Ave, Tampa, FL 33606-3511 | 2019-05-16 |
| 1932682846 | Ferrara Dental Pllc | Dentist | 201 East Kennedy Blvd, Suite 1425, Tampa, FL 33602 | 2018-09-07 |
| 1275014839 | Raouf Morcos | Dentist | 2605 W Swann Ave Ste 200, Tampa, FL 33609-4039 | 2018-08-22 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1548753825 | Melissa Ann Jones | Dentist | 3680 W Gandy Blvd, Tampa, FL 33611-2608 | 2018-06-11 |
| 1326599168 | Andrew Blake Brattain | Dentist | 13022 Race Track Rd, Ste 101, Tampa, FL 33626-1302 | 2016-10-17 |
| 1568910990 | Usman Zafar | Dentist | 2519 Cedar Cypress Ct Unit 202, Tampa, FL 33618-3482 | 2016-09-14 |
| Find all providers in TAMPA | ||||
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| 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.