NPIMap

Organization Active NPI

Eley Family Dentistry, P.a.

  • Dentist
  • Melbourne, FL
National Provider Identifier
1033539085
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19369 Issued in FL
Legal business name
ELEY FAMILY DENTISTRY, P.A.
Practice address
2301 W Eau Gallie Blvd
Suite #102
Melbourne, FL 32935-3120
Phone
(321) 622-8711
Fax
(321) 622-8712
NPI assigned
Apr 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Daniel Warren Eley, D.M.D.NPI 1952696007
Title
President
Phone
(321) 622-8711

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DN19369 FL Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X DN22269 GA

Addresses

Primary practice location

2301 W Eau Gallie Blvd
Suite #102
Melbourne, FL 32935-3120

Mailing address

2301 W Eau Gallie Blvd
Suite #102
Melbourne, FL 32935-3120
Phone (321) 622-8711

National Provider Directory

National Provider Directory

Locations

2301 W Eau Gallie Blvd
Ste 102
Melbourne, FL 32935
Phone (321) 622-8711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473724800000",
    "number": "1033539085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W EAU GALLIE BLVD",
            "address_2": "SUITE #102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353120",
            "telephone_number": "321-622-8711",
            "fax_number": "321-622-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W EAU GALLIE BLVD",
            "address_2": "SUITE #102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353120",
            "telephone_number": "321-622-8711",
            "fax_number": "321-622-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEY FAMILY DENTISTRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2016-09-13",
        "status": "A",
        "authorized_official_last_name": "ELEY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-622-8711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19369",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN22269",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.