Individual provider Active NPI

Dominic Morel-Maynard, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Delray Beach, FL
National Provider Identifier
1073800520
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN 21761 Issued in FL
Practice address
15340 S Jog Rd Ste 100
Delray Beach, FL 33446-2170
Phone
(561) 495-2099
NPI assigned
Jul 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN 21761 FL Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN21761 FL
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 2018010876 MO

Addresses

Primary practice location

15340 S Jog Rd Ste 100
Delray Beach, FL 33446-2170

Mailing address

5720 Fox Hollow Dr Apt C
Boca Raton, FL 33486-8928
Phone (917) 703-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21761FLMDOral and Maxillofacial Surgery (Dentist)
DN21761FLMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Morel Espinal Dentistry, PA CurrentSince Mar 11, 2025 Accepting new patients
Profiles II Oral and Facial Surgery ,PLLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1073800520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 FOX HOLLOW DR APT C",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334868928",
            "telephone_number": "917-703-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15340 S JOG RD STE 100",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334462170",
            "telephone_number": "561-495-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREL-MAYNARD",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 21761",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN21761",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2018010876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.