Active NPI
Michelle Nudel
- Dentist
- Boca Raton, FL
National Provider Identifier
1790528057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 29079
- Practice address
- 200 E Palmetto Park Rd # TH14
Boca Raton, FL 33432-5623 - Phone
- (561) 374-0624
- NPI assigned
- Jun 14, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 29079 | FL | Primary |
Addresses
Primary practice location
200 E Palmetto Park Rd # TH14
Boca Raton, FL 33432-5623
Mailing address
200 E Palmetto Park Rd # TH14
Boca Raton, FL 33432-5623
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29079 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1790528057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E PALMETTO PARK RD # TH14",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334325623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E PALMETTO PARK RD # TH14",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334325623",
"telephone_number": "561-374-0624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUDEL",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-14",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "29079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boca Raton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.