Marnelli Deborah Geronimo Tan

General Practice Dentistry · Gibsonton, FL

Individual Active NPI

NPI number 1457277386

Practice location

13127 Kings Lake Dr Unit 101
Gibsonton, FL 33534-3958
Phone
(813) 677-3047

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NPI record

NPI
1457277386
Entity type
Individual (Type 1)
Enumeration date
June 25, 2026
Last updated
June 25, 2026
Certified
June 4, 2026
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DN32087 FL

Mailing address

411 Carriage Crossing Cir
Brandon, FL 33510-2178

About Marnelli Tan

Marnelli Deborah Geronimo Tan is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 13127 Kings Lake Dr Unit 101, Gibsonton, FL 33534-3958. The NPI number 1457277386 was assigned on June 25, 2026 and the record was last updated on June 25, 2026.

Marnelli Tan lists a license in the registry: #DN32087 (FL) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Marnelli Deborah Geronimo Tan?

The NPI number is 1457277386.

What is the phone number of Marnelli Tan?

The phone number listed for the practice location is (813) 677-3047.

Where is Marnelli Tan located?

13127 Kings Lake Dr Unit 101, Gibsonton, FL 33534-3958.

What is the taxonomy code for Marnelli Tan?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.