Individual provider Active NPI

Melby Llanes Morell, DMD

  • Dentist
  • Davie, FL
National Provider Identifier
1235974569
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN29270 Issued in FL
Practice address
5796 S University Dr Ste 102
Davie, FL 33328-6119
Phone
(954) 248-2742
NPI assigned
Jun 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN29270 FL Primary

Addresses

Primary practice location

5796 S University Dr Ste 102
Davie, FL 33328-6119

Mailing address

5796 S University Dr Ste 102
Davie, FL 33328-6119
Phone (954) 248-2742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240930000049 FL Order and Referring Only - DentistPractitioner - Dentist 6002347218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN29270FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Davie Modern Dentistry, PA PastSince Jun 30, 2024 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1235974569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5796 S UNIVERSITY DR STE 102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333286119",
            "telephone_number": "954-248-2742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5796 S UNIVERSITY DR STE 102",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333286119",
            "telephone_number": "954-248-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLANES MORELL",
        "first_name": "MELBY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN29270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.