Healthcare Provider Details

I. General information

NPI: 1013853951
Provider Name (Legal Business Name): TOOTH TROOP DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2541 WINDGUARD CIR
WESLEY CHAPEL FL
33544-7349
US

IV. Provider business mailing address

2541 WINDGUARD CIR
WESLEY CHAPEL FL
33544-7349
US

V. Phone/Fax

Practice location:
  • Phone: 407-259-1161
  • Fax: 813-768-0583
Mailing address:
  • Phone: 407-259-1161
  • Fax: 813-768-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JAY SKIPPER
Title or Position: MEMBER
Credential: DDS
Phone: 272-212-1820