Provider Demographics
NPI:1497562979
Name:TDN DENTISTRY, PLLC
Entity type:Organization
Organization Name:TDN DENTISTRY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSCARO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-692-2200
Mailing Address - Street 1:4890 W KENNEDY BLVD STE 920
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1850
Mailing Address - Country:US
Mailing Address - Phone:813-692-2200
Mailing Address - Fax:
Practice Address - Street 1:4890 W KENNEDY BLVD STE 9204890W
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1851
Practice Address - Country:US
Practice Address - Phone:813-692-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TDN DENTISTRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-17
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty