=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841157906
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEF TEMPLE TERRACE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/08/2026
-----------------------------------------------------
Last Update Date | 01/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10320 N 56TH ST STE 300
-----------------------------------------------------
City | TEMPLE TERRACE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33617-4057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-513-0025
-----------------------------------------------------
Fax | 813-513-0035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10320 N 56TH ST STE 300
-----------------------------------------------------
City | TEMPLE TERRACE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33617-4057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-513-0025
-----------------------------------------------------
Fax | 813-513-0035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS MANAGER
-----------------------------------------------------
Name | EMTEYAZ ASKER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 813-458-0257
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------