NPIMap

Organization Active NPI

Mujeeb DDS,PA

  • Point of Service
  • Melbourne, FL
National Provider Identifier
1801219159
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
DN13401 Issued in FL
Legal business name
MUJEEB DDS,PA
Practice address
3226 Lake Washington Rd
# 16
Melbourne, FL 32934-7620
Phone
(321) 255-1991
Fax
(321) 752-0011
NPI assigned
Jan 22, 2014
Organization subpart
Yes
Parent organization
NEW IMAGE DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Alma Balchuck
Title
Manager
Phone
(321) 255-1991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X DN13401 FL Primary

Addresses

Primary practice location

3226 Lake Washington Rd
# 16
Melbourne, FL 32934-7620

Mailing address

3226 Lake Washington Rd
# 16
Melbourne, FL 32934-7620
Phone (321) 255-1991

National Provider Directory

National Provider Directory
Tax ID family
Mujeeb Ddspa2 organizations share this tax ID, including this one
Part of
Mujeeb Ddspa

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3226 Lake Washington Rd
#16
Melbourne, FL 32934
Phone (321) 255-1991

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1801219159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 LAKE WASHINGTON RD",
            "address_2": "# 16",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347620",
            "telephone_number": "321-255-1991",
            "fax_number": "321-752-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 LAKE WASHINGTON RD",
            "address_2": "# 16",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347620",
            "telephone_number": "321-255-1991",
            "fax_number": "321-752-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUJEEB DDS,PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW IMAGE DENTISTRY",
        "enumeration_date": "2014-01-22",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "BALCHUCK",
        "authorized_official_first_name": "ALMA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "321-255-1991"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "FL",
            "license": "DN13401",
            "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 Jan 22, 2014; 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.