Organization Active NPI

Affordable Dentures & Implants - West Melbourne II, P.a.

  • General Practice Dentistry
  • West Melbourne, FL
National Provider Identifier
1265249676
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AFFORDABLE DENTURES & IMPLANTS - WEST MELBOURNE II, P.A.
Practice address
1529 W New Haven Ave
West Melbourne, FL 32904-3927
Phone
(321) 725-6570
NPI assigned
Dec 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Mark Coulter, DDS
Title
Owner
Phone
(321) 725-6570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1529 W New Haven Ave
West Melbourne, FL 32904-3927

Mailing address

1529 W New Haven Ave
West Melbourne, FL 32904-3927
Phone (321) 725-6570

Other names 1

  • Affordable Dentures & Implants - West Melbourne Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1265249676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 W NEW HAVEN AVE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043927",
            "telephone_number": "321-725-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 W NEW HAVEN AVE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043927",
            "telephone_number": "321-725-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - WEST MELBOURNE II, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "COULTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-725-6570",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - West Melbourne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.