MEDICARE: THE TOOTH SHOP ON 46

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1932850385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE TOOTH SHOP ON 46

Provider Business Mailing Address
First Line	:	25520 STATE ROAD 46
Second Line	:
City	:	SORRENTO
State	:	FL
Zip	:	32776-9526
Country	:	US
Telephone Number	:	352-735-2211
Fax Number	:	352-735-5844

Provider Business Practice Location Address
First Line	:	25520 STATE ROAD 46
Second Line	:
City	:	SORRENTO
State	:	FL
Zip	:	32776-9526
Country	:	US
Telephone Number	:	352-735-2211
Fax Number	:	352-735-5844

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. DANA SYSKA
Credential	:
Telephone Number	:	352-391-4231

Provider Enumeration Date	:	01/17/2022
Last Update Date	:	01/17/2022

Similar Medicare Providers

1174565881 — RONALD E HOLMAN, DDS,PA
Practice Location Address:

25520 STATE ROAD 46
SORRENTO, FL
32776-9526

Practice Phone: 352-735-2212
Practice Fax:

1053531095 — DR. NILES A. SYSKA D.D.S.
Practice Location Address:

25520 STATE ROAD 46
SORRENTO, FL
32776-9526

Practice Phone: 352-735-2211
Practice Fax: 352-735-5844

1538336771 — RONALD E HOLMAN D.D.S.
Practice Location Address:

25520 STATE ROAD 46
SORRENTO, FL
32776-9526

Practice Phone: 352-735-2211
Practice Fax: 352-735-5844

1902499338 — THE TOOTH SHOP OF OCALA, LLC
Practice Location Address:

25520 STATE ROAD 46
SORRENTO, FL
32776-9526

Practice Phone: 352-735-2211
Practice Fax: 352-735-5844

1578538062 — MRS. LINDA MARIE GIBSON-YOUNG CRNP
Practice Location Address:

31337 PRESTWICK AVE
SORRENTO, FL
32776-9023

Practice Phone: 205-515-6491
Practice Fax:

1013944933 — GEORGE RAYMOND IKELER M.D.
Practice Location Address:

31450 CHURCH ST
SORRENTO, FL
32776-9594

Practice Phone: 352-735-4033
Practice Fax: 352-735-2536

Directions to “THE TOOTH SHOP ON 46 ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.