NPIMap

Organization Active NPI

Coast Florida P.a.

Doing business as Coast Dental-Melbourne

  • General Practice Dentistry
  • Melbourne, FL
National Provider Identifier
1396312096
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COAST FLORIDA P.A.
Doing business as
Coast Dental-Melbourne
Practice address
7777 N Wickham Rd Ste 4
Melbourne, FL 32940-7978
Phone
(321) 255-6303
Fax
(321) 255-6710
NPI assigned
Jun 10, 2021
Last updated
Jun 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COAST FLORIDA P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Melody Rivera
Title
Credentialing Manager
Phone
(813) 350-7166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

7777 N Wickham Rd Ste 4
Melbourne, FL 32940-7978

Mailing address

5706 Benjamin Center Dr Ste 103
Tampa, FL 33634-5262
Phone (813) 350-7166

Other names 1

  • Coast Dental-Melbourne Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coast Florida PA47 organizations share this tax ID, including this one
Part of
Coast Florida PA

Other organizations with this tax ID 46

Organizations that report the same tax identification number in the National Provider Directory.

View all 46

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1396312096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 BENJAMIN CENTER DR STE 103",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336345262",
            "telephone_number": "813-350-7166",
            "fax_number": "813-434-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 N WICKHAM RD STE 4",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407978",
            "telephone_number": "321-255-6303",
            "fax_number": "321-255-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST FLORIDA P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COAST FLORIDA P.A.",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MELODY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "813-350-7166"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Dental-Melbourne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 10, 2021; 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.