<unavail> in Tampa, FL - Medicare Dentist

is a medicare enrolled dental clinic (Dentist) in Tampa, Florida. The current practice location for is 4302 Henderson Blvd Ste 111, Tampa, Florida. For appointments, you can reach them via phone at (813) 768-0807. The mailing address for is 4302 Henderson Blvd Ste 111, Tampa, Florida and phone number is (813) 768-0807.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1073384277. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (813) 768-0807.

Contact Information


	4302 Henderson Blvd Ste 111 Tampa FL 33629-5693
	(813) 768-0807
	(813) 839-2206

Map and Direction

Dental Care Clinic Profile

Full Name
Speciality	Dentist
Location	4302 Henderson Blvd Ste 111, Tampa, Florida
Authorized Official Name and Position	Jennifer Nicole Vega (PRACTICE MANAGER)
Authorized Official Contact	8138392273
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
4302 Henderson Blvd Ste 111 Tampa FL 33629-5693 Ph: (813) 768-0807	4302 Henderson Blvd Ste 111 Tampa FL 33629-5693 Ph: (813) 768-0807

NPI Details:

NPI Number	1073384277
Provider Enumeration Date	01/16/2024
Last Update Date	01/22/2025

Medicare PECOS Information:

Medicare PECOS PAC ID	2860839834
Medicare Enrollment ID	O20240326002855

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073384277	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	(* (Not Available))	Primary
332B00000X	Durable Medical Equipment & Medical Supplies	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Marnie C Bauer
Provider Type	Practitioner - Dentist
Provider Identifiers	NPI Number: 1013124387 PECOS PAC ID: 9335584390 Enrollment ID: I20240327001506

Reviews and Comments

Dental Clinics in Tampa, FL

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Mangrove Bay Dentistry P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13998 W Hillsborough Ave, Tampa, FL 33635 Phone: 813-891-9898
Solsmile Lounge Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8905 Regents Park Dr Ste 250, Tampa, FL 33647 Phone: 813-333-9192
Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 W Fletcher Ave, Tampa, FL 33612 Phone: 813-961-1727 Fax: 813-968-7220
Toothache Center Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 12425 N Florida Ave, Tampa, FL 33612 Phone: 813-932-7400 Fax: 813-935-5353

- Medicare Dental Clinic in Tampa, FL