MEDICARE: DENTAL SEDATION CENTERS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1558214437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL SEDATION CENTERS PLLC

Provider Business Mailing Address
First Line	:	8383 SEMINOLE BLVD STE A
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8383 SEMINOLE BLVD STE A
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-4392
Country	:	US
Telephone Number	:	813-336-8478
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST/CEO
Name	:	VINCENT MONTICCIOLO
Credential	:
Telephone Number	:	813-336-8478

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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