Organization Active NPI

Zrallack Dental

  • Dentist
  • Titusville, FL
National Provider Identifier
1063508141
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14970 Issued in FL
Legal business name
ZRALLACK DENTAL
Practice address
2670 Garden St
Titusville, FL 32796-3176
Phone
(321) 267-7970
Fax
(321) 264-9289
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Michele Zrallack, D.M.D.NPI 1255500732
Title
Dentist
Phone
(321) 267-7970

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14970 FL Primary

Addresses

Primary practice location

2670 Garden St
Titusville, FL 32796-3176

Mailing address

2670 Garden St
Titusville, FL 32796-3176
Phone (321) 267-7970

National Provider Directory

National Provider Directory

Locations

2670 Garden St
Titusville, FL 32796
Phone (321) 267-1526

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063508141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963176",
            "telephone_number": "321-267-7970",
            "fax_number": "321-264-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327963176",
            "telephone_number": "321-267-7970",
            "fax_number": "321-264-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZRALLACK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZRALLACK",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "321-267-7970",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "14970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.