Individual provider Active NPI

Mishall Waheed

  • Dentist
  • West Melbourne, FL
National Provider Identifier
1578285151
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN27507 Issued in FL
Practice address
2235 W New Haven Ave
West Melbourne, FL 32904-3800
Phone
(321) 956-5664
NPI assigned
Sep 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN27507 FL Primary

Addresses

Primary practice location

2235 W New Haven Ave
West Melbourne, FL 32904-3800

Mailing address

2235 W New Haven Ave
West Melbourne, FL 32904-3800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN27507FLMDDentist

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1662940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1578285151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 W NEW HAVEN AVE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 W NEW HAVEN AVE",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329043800",
            "telephone_number": "321-956-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHEED",
        "first_name": "MISHALL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-12",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.