Active NPI
Melissa I Obrochta, D.M.D.
- General Practice Dentistry
- Miami Lakes, FL
National Provider Identifier
1265621015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN18067
- Practice address
- 15436 NW 77TH CT
Miami Lakes, FL 33016-5822 - Phone
- (305) 557-5775
- NPI assigned
- Oct 17, 2007
- Last updated
- Sep 8, 2016
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN18067 | FL | Primary |
Addresses
Primary practice location
15436 NW 77TH CT
Miami Lakes, FL 33016-5822
Mailing address
62 Matador LN
Davie, FL 33324-5542
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 |
|---|---|---|---|
| DN18067 | FL | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aesthetic Dental PA | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473292800000",
"number": "1265621015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 MATADOR LN",
"city": "DAVIE",
"state": "FL",
"postal_code": "333245542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15436 NW 77TH CT",
"city": "MIAMI LAKES",
"state": "FL",
"postal_code": "330165822",
"telephone_number": "305-557-5775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBROCHTA",
"first_name": "MELISSA",
"middle_name": "I",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-17",
"last_updated": "2016-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami Lakes, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.