Michael Muztafago Jr.

Primary specialty

DentistTaxonomy code 122300000X

License

0401415255 Issued in VA

Practice address

3716 Melrose Ave NW
Roanoke, VA 24017-2716

Phone

(540) 362-0360

NPI assigned

Jun 13, 2016

Sex

Male

Sole proprietor

Yes

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

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1265881056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172716",
            "telephone_number": "540-362-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 MELROSE AVE NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172716",
            "telephone_number": "540-362-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUZTAFAGO",
        "first_name": "MICHAEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Katherine Musick
• Melissa Muskopf, PHARMD
• Karin Christine Musselman, FNP
• Carl W Musser Jr., M.D.
• Katherine Emel Mustafa
• Valentine Mwangi, DO
• My Village LLC (The Breastfeeding Center of Roanoke)
• My Wellness Watch PC
• Elmarie Myburgh, BS, MPT
• Victor Paure Myburgh, BS, PT

• Dentist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.