Nicole Sarah Ishak, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29493 Issued in FL

Practice address

2328 Citadel Way Ste 101
Melbourne, FL 32940-6192

Phone

(321) 203-5251

NPI assigned

Aug 5, 2024

Last updated

Aug 5, 2024By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dentists of Melbourne, PA

  dba Dentists of Melbourne

  • Dentist
  • Melbourne, FL
  • NPI 1871006742
  NPD (past)
• Viera Modern Dentistry, PA

  • Dentist
  • Melbourne, FL
  • NPI 1144746116
  NPD (past)

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1285464297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2328 CITADEL WAY STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329406192",
            "telephone_number": "321-203-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2328 CITADEL WAY STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329406192",
            "telephone_number": "321-203-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6455 N Wickham Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329402020",
            "country_code": "US",
            "telephone_number": "321-420-4142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISHAK",
        "first_name": "NICOLE",
        "middle_name": "SARAH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "29493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Ramon Irizarry, MD
• Errol Joel Isaac
• Isenman Wellness Care LLC
• Eric C Isenman, MD
• Martin W. Isenman, MD
• Dan Ishihara, M.D., PH.D.
• Rachel Isma, DPM
• Steven Laurence Israel, M.D.
• Abdimomun Iuldashev, M.D.
• Andrea Izquierdo, DOM, LAC

• General Practice Dentistry in Melbourne, FL
• Providers in Melbourne, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.