Individual provider Active NPI

Melissa I Obrochta, D.M.D.

  • General Practice Dentistry
  • Miami Lakes, FL
National Provider Identifier
1265621015
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN18067 Issued in FL
Practice address
15436 NW 77TH CT
Miami Lakes, FL 33016-5822
Phone
(305) 557-5775
NPI assigned
Oct 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
DN18067FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Dental PA PastSince Dec 29, 2024 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 and National Provider Directory roles.

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.

Verify at the official NPI Registry.