Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fl Southern Dental PPO PA

Organization Dentist · NPI 1275473704

Fl Southern Dental PPO PA is a Dentist in Tampa, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3910 Northdale Blvd Ste 102A
Tampa, FL 33624-1800
Phone: (813) 969-0294
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1275473704
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFl Southern Dental PPO PA
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Northdale-Dental Health Services
NPI enumeratedApril 1, 2026
Last updated in NPPESApril 1, 2026
Certification dateApril 1, 2026
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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