Provider Demographics
NPI:1164842357
Name:TINDELL, BARRETT
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:
Last Name:TINDELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-3424
Mailing Address - Country:US
Mailing Address - Phone:813-961-1727
Mailing Address - Fax:813-968-7220
Practice Address - Street 1:801 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3424
Practice Address - Country:US
Practice Address - Phone:813-961-1727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-26
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 211621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice