Provider Demographics
NPI:1366540270
Name:ADAM DIASTI DDS & ASSOCIATES P.C.
Entity type:Organization
Organization Name:ADAM DIASTI DDS & ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GERERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-288-1999
Mailing Address - Street 1:2502 N ROCKY POINT DR
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-1421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2502 N ROCKY POINT DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1421
Practice Address - Country:US
Practice Address - Phone:813-288-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty