NPIMap

Organization Active NPI

Ray L Pollack & Associates DDS PA

  • Pediatric Dentistry
  • Melbourne, FL
National Provider Identifier
1265573638
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
RAY L POLLACK & ASSOCIATES DDS PA
Practice address
1325 S Pine St
Suite #103
Melbourne, FL 32901-3187
Phone
(321) 724-4520
Fax
(321) 723-9762
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Raymond Lyle Pollock, DDSNPI 1548301906
Title
President
Phone
(321) 724-4520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1325 S Pine St
Suite #103
Melbourne, FL 32901-3187

Mailing address

1325 S Pine St
Suite #103
Melbourne, FL 32901-3187
Phone (321) 724-4520

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265573638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S PINE ST",
            "address_2": "SUITE #103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013187",
            "telephone_number": "321-724-4520",
            "fax_number": "321-723-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S PINE ST",
            "address_2": "SUITE #103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013187",
            "telephone_number": "321-724-4520",
            "fax_number": "321-723-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAY L POLLACK & ASSOCIATES DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLLOCK",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-724-4520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.