Maryam Brazdo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN18392 Issued in FL

Practice address

1061 S Wickham Rd
Melbourne, FL 32904-1652

Phone

(321) 722-0155

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Maryam Brazdo, DMD, PA

  • General Practice Dentistry
  • Melbourne, FL
  • NPI 1295000339
  NPD (past) Authorized official

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1265694236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 S WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-243-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 S WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-722-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZDO",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN18392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Braun, LMHC
• Mindy Jaree Braun
• Rayna M Bravo, LMHC
• Tabitha Renee Brawley, M.S.
• Shannon Bray, MSN, APRN, FNP-C
• Natalie Brecese, CAA
• Elizabeth Ann Breck, LCSW
• Audrius J Bredikis, M.D.
• Larry Jay Brendle, R.PH.
• Holly Brennan, RD

• Dentist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.