Individual provider Active NPI

Michael David Hosking, DDS

  • Endodontics
  • Melbourne, FL
National Provider Identifier
1811244791
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN23144 Issued in FL
Practice address
5600 Porada Dr Ste 102
Melbourne, FL 32940-8082
Phone
(321) 754-9988
Fax
(321) 754-9988
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 30798 TX
Endodontics 1223E0200X DN23144 FL Primary

Addresses

Primary practice location

5600 Porada Dr Ste 102
Melbourne, FL 32940-8082

Mailing address

4978 Duson Way
Rockledge, FL 32955-7003

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23144FLMDEndodontist
30798TXMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Space Coast Endodontics, PLLC Endodontics CurrentSince Nov 29, 2020 Accepting new patients
Specialty1Partners Endodontics PastSince Aug 1, 2022 Accepting new patients

Locations

5600 Porada Dr
Ste 102
Viera, FL 32940
Phone (321) 417-0107

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1811244791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4978 DUSON WAY",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329557003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 PORADA DR STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408082",
            "telephone_number": "321-754-9988",
            "fax_number": "321-754-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSKING",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "30798",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN23144",
            "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 Nov 24, 2020; 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.