Active NPI
Tiffany Melissa Dudley, DDS
- Dentist
- Delray Beach, FL
National Provider Identifier
1679720247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN18099
- Practice address
- 3911 W Atlantic Ave
Delray Beach, FL 33445-3902 - Phone
- (561) 498-0050
- Fax
- (561) 498-0841
- NPI assigned
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN18099 | FL | Primary |
| Dentist | 122300000X | 2901019615 | MI |
Addresses
Primary practice location
3911 W Atlantic Ave
Delray Beach, FL 33445-3902
Mailing address
3911 W. Atlantic Ave
Delray Beach, FL 33445
Phone (561) 498-0050
Other names 1
- Dr. Tiffany Melissa Stafiej
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191010002225 | FL | Order and Referring Only - Dentist | 6800126988 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN18099 | FL | MD | Dentist |
| 2901019615 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417996800000",
"number": "1679720247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3911 W. ATLANTIC AVE",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "33445",
"telephone_number": "561-498-0050",
"fax_number": "561-498-0841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3911 W ATLANTIC AVE",
"city": "DELRAY BEACH",
"state": "FL",
"postal_code": "334453902",
"telephone_number": "561-498-0050",
"fax_number": "561-498-0841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "TIFFANY",
"middle_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2014-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN18099",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901019615",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TIFFANY",
"last_name": "STAFIEJ",
"middle_name": "MELISSA",
"prefix": "DR.",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Delray Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.