Paul Ludwig Ouellette, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0006097 Issued in FL

Practice address

455 Magnolia Ave
Merritt Island, FL 32952-4838

Phone

(321) 453-7750

Fax

(321) 453-4966

NPI assigned

Apr 17, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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.

• Dental Specialists of Central Florida

  • General Practice Dentistry
  • Merritt Island, FL
  • NPI 1336459064
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861617409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 MAGNOLIA AVE",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524838",
            "telephone_number": "321-453-7750",
            "fax_number": "321-453-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 MAGNOLIA AVE",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329524838",
            "telephone_number": "321-453-7750",
            "fax_number": "321-453-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "PAUL",
        "middle_name": "LUDWIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "0006097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Orme, BSW, RBT
• Orthopedic Associates, PA
• Zigrid D. Ortiz
• Penelope Ostarly
• Jason Patrick Ouellette, D.D.S.
• Our House Alf, Inc.
• Heather Jean Ovales
• Calvi Enid Pabon-Nadal, MD
• Pain Management of Brevard PLC
• Jenny Pambianchi, PTA

• Orthodontics and Dentofacial Orthopedics Dentistry in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.