=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932909470
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TILLINGER DENTAL PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2025
-----------------------------------------------------
Last Update Date | 03/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4300 ALTON RD # 1190
-----------------------------------------------------
City | MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33140-2948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-770-3300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 340 ROYAL POINCIANA WAY STE 317-319
-----------------------------------------------------
City | PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33480-4048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-770-3300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JOSHUA TILLINGER
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 954-770-3300
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------