MEDICARE: SIGNATURE SMILES OF TAMPA, PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1184447906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGNATURE SMILES OF TAMPA, PLLC

Provider Business Mailing Address
First Line	:	3814 WEST BAY VISTA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1226
Country	:	US
Telephone Number	:	813-302-9282
Fax Number	:	813-302-9342

Provider Business Practice Location Address
First Line	:	3814 WEST BAY VISTA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1226
Country	:	US
Telephone Number	:	813-302-9282
Fax Number	:	813-302-9342

Authorized Official
Title or Position	:	EMPLOYEE
Name	:	KHANTIL R. SHAH
Credential	:	DMD
Telephone Number	:	813-302-9282

Provider Enumeration Date	:	11/01/2024
Last Update Date	:	11/01/2024

Similar Medicare Providers

1710393806 — ALL DENTAL TAMPA, INC
Practice Location Address:

3814 W BAY VISTA AVE
TAMPA, FL
33611-1226

Practice Phone: 813-837-2380
Practice Fax: 813-837-2381

1629250857 — BIO MEDICAL APPLICATIONS
Practice Location Address:

5625 W WATERS AVE STE A
TAMPA, FL
33634-1226

Practice Phone: 813-884-8849
Practice Fax: 813-884-8819

1376776989 — CELESTE CHRISTINE MURPHY-PALUMBO L.M.T.
Practice Location Address:

12914 N 56TH ST
TAMPA, FL
33617-1226

Practice Phone: 813-988-7568
Practice Fax:

1023435492 — SERENITY LIFE ADULT DAY CARE CENTER INC
Practice Location Address:

5625 W WATERS AVE STE G
TAMPA, FL
33634-1226

Practice Phone: 813-888-1200
Practice Fax: 813-882-4830

1902342207 — TAKE A BREAK BABYSITTING, INC
Practice Location Address:

1226 E COMANCHE AVE
TAMPA, FL
33604-7226

Practice Phone: 813-283-8224
Practice Fax:

1174322499 — RICHARD WEERTS
Practice Location Address:

1226 E CUMBERLAND AVE UNIT 409
TAMPA, FL
33602-4236

Practice Phone: 847-867-0339
Practice Fax:

Directions to “SIGNATURE SMILES OF TAMPA, PLLC ” 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.