NPIMap

Organization Active NPI

Vijay Agarwal DDS PA

  • Dentist
  • Melbourne, FL
National Provider Identifier
1477947604
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN14989 Issued in FL
Legal business name
VIJAY AGARWAL DDS PA
Practice address
2330 N Wickham Rd
Suite 3
Melbourne, FL 32935-8182
Phone
(321) 255-3311
Fax
(321) 255-8973
NPI assigned
Mar 25, 2015
Last updated
Mar 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Dr. Vijay Agarwal, DDSNPI 1861587917
Title
President
Phone
(321) 255-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DN14989 FL Primary

Addresses

Primary practice location

2330 N Wickham Rd
Suite 3
Melbourne, FL 32935-8182

Mailing address

2330 N Wickham Rd
Suite 3
Melbourne, FL 32935-8182
Phone (321) 255-3311

National Provider Directory

National Provider Directory

Locations

2330 N Wickham Rd
Ste 3
Melbourne, FL 32935
Phone (321) 255-3311

Practitioners & affiliated clinicians

Practitioners 1

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": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1477947604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 N WICKHAM RD",
            "address_2": "SUITE 3",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358182",
            "telephone_number": "321-255-3311",
            "fax_number": "321-255-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 N WICKHAM RD",
            "address_2": "SUITE 3",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358182",
            "telephone_number": "321-255-3311",
            "fax_number": "321-255-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIJAY AGARWAL DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-255-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN14989",
            "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 Mar 25, 2015; 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.