Healthcare Provider Details

I. General information

NPI: 1134946353
Provider Name (Legal Business Name): TDN DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 37TH ST STE 401
VERO BEACH FL
32960-7322
US

IV. Provider business mailing address

4890 W KENNEDY BLVD STE 920
TAMPA FL
33609-1850
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-9700
  • Fax: 772-569-9704
Mailing address:
  • Phone: 813-692-2200
  • Fax: 813-692-2205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY MUSCARO
Title or Position: OWNER
Credential: DDS
Phone: 813-692-2205