NPIMap

Organization Active NPI

Department of Veterans Affairs

  • Dental Clinic/Center
  • Melbourne, FL
National Provider Identifier
1376736967
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DH 17979 Issued in FL
Legal business name
DEPARTMENT OF VETERANS AFFAIRS
Practice address
2900 Veterans Way
Melbourne, FL 32940-8007
Phone
(321) 637-3646
NPI assigned
Aug 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Lisa Gorman
Title
Lead Dentist
Phone
(321) 637-3646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DH 17979 FL Primary

Addresses

Primary practice location

2900 Veterans Way
Melbourne, FL 32940-8007

Mailing address

2900 Veterans Way
Melbourne, FL 32940-8007

National Provider Directory

National Provider Directory
Tax ID family
James a Haley Veterans' Hospital179 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1376736967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LEAD DENTIST",
        "authorized_official_telephone_number": "321-637-3646"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DH 17979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; 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.