Active NPI
Coast Dental P.a.
Doing business as Coast Dental-Merritt Island
- Dentist
- Merritt Island, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Legal business name
- COAST DENTAL P.A.
- Doing business as
- Coast Dental-Merritt Island
- Practice address
- 229 Crockett Blvd
Merritt Island, FL 32953-4384 - Phone
- (321) 449-0833
- Fax
- (321) 449-0832
- NPI assigned
- May 27, 2021
- Last updated
- May 27, 2021
- Organization subpart
- Yes
- Parent organization
- COAST DENTAL P.A.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melody Rivera
- Title
- Credentialing Manager
- Phone
- (813) 350-7166
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | Primary |
Addresses
Primary practice location
229 Crockett Blvd
Merritt Island, FL 32953-4384
Mailing address
5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262
Phone (813) 288-1999
Other names 1
- Coast Dental-Merritt Island
National Provider Directory
National Provider Directory- Tax ID family
- Coast Dental PA
- Part of
- Coast Dental PA
Other organizations with this tax ID 31
Organizations that report the same tax identification number in the National Provider Directory.
Locations
229 Crockett Blvd
Merritt Island, FL 32953
Phone (321) 449-0833
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Dentist
- Tampa, FL
- NPI 1992803860
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Dental Hygienist
- Merritt Island, FL
- NPI 1396348231
-
- General Practice Dentistry
- Merritt Island, FL
- NPI 1629189147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622073600000",
"number": "1114593449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5706 BENJAMIN CENTER DR STE 103",
"city": "TAMPA",
"state": "FL",
"postal_code": "336345262",
"telephone_number": "813-288-1999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 CROCKETT BLVD",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "329534384",
"telephone_number": "321-449-0833",
"fax_number": "321-449-0832"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COAST DENTAL P.A.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COAST DENTAL P.A.",
"enumeration_date": "2021-05-27",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A",
"authorized_official_last_name": "RIVERA",
"authorized_official_first_name": "MELODY",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "813-350-7166"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Coast Dental-Merritt Island",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.