Mark David Mellman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN8712 Issued in FL

Practice address

721 W. Robertson St.
Suite 107
Brandon, FL 33511

Phone

(813) 654-4545

Fax

(813) 654-3470

NPI assigned

Oct 1, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark D. Mellman, DDS. PA

  • Dental Clinic/Center
  • Brandon, FL
  • NPI 1578585451
  NPD (past) Authorized official

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1700213188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W. ROBERTSON ST.",
            "address_2": "SUITE 107",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-654-4545",
            "fax_number": "813-654-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W. ROBERTSON ST.",
            "address_2": "SUITE 107",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "813-654-4545",
            "fax_number": "813-654-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLMAN",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN8712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly M Meek
• Dhirendra Indulal Mehta, M.D.
• Magda Elkabani Melchert, MD
• Mary Elizabeth Melendez, D.C.
• Amber Melero, PA-C
• Soomal Zukhruf Memon
• Edgar Alain Mendez Novo
• Luisel Mendez Ruiz
• Kelli Mendola, OTR/L
• Christian Mendoza, PA-C

• Dentist in Brandon, FL
• Providers in Brandon, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.

Verify at the official NPI Registry.