Active NPI
Michele Zrallack, DMD
- Dentist
- Titusville, FL
National Provider Identifier
1255500732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14970
- Practice address
- 2670 Garden St
Titusville, FL 32796-3176 - Phone
- (321) 267-7970
- Fax
- (321) 264-9289
- NPI assigned
- Feb 28, 2008
- Last updated
- Feb 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14970 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zrallack Dental | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Titusville, FL
- NPI 1063508141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204156800000",
"number": "1255500732",
"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": {
"last_name": "ZRALLACK",
"first_name": "MICHELE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-28",
"last_updated": "2008-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_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 Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.