Kenneth a Mogell DMD PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN10118 Issued in FL

Legal business name

KENNETH A MOGELL DMD PA

Practice address

1400 Pine St Ste a
Melbourne, FL 32901-3170

Phone

(321) 313-5350

Fax

(561) 988-1102

NPI assigned

Apr 27, 2018

Last updated

Apr 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Annette Mogell

Title

Sec/Treas

Phone

(561) 271-2483

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1285122044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N MILITARY TRL STE 212",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PINE ST STE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013170",
            "telephone_number": "321-313-5350",
            "fax_number": "561-988-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH A MOGELL DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "MOGELL",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "SEC/TREAS",
        "authorized_official_telephone_number": "561-271-2483"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN10118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Apr 27, 2018; 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.