NPIMap

Organization Active NPI

Natalia Valderrama, DDS, PA

Doing business as Valderrama Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Melbourne, FL
National Provider Identifier
1861877102
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN19651 Issued in FL
Legal business name
NATALIA VALDERRAMA, DDS, PA
Doing business as
Valderrama Orthodontics
Practice address
903 Jordan Blass Dr Ste 102
Melbourne, FL 32940-1325
Phone
(321) 544-4127
NPI assigned
Jul 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Dr. Natalia Valderrama Dougherty, DDS, MSNPI 1275880742
Title
President/Owner
Phone
(904) 434-7783

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X DN19651 FL Primary
Dental Clinic/Center 261QD0000X DN19651 FL

Addresses

Primary practice location

903 Jordan Blass Dr Ste 102
Melbourne, FL 32940-1325

Mailing address

976 Wildwood Dr
Melbourne, FL 32940-1506
Phone (904) 434-7783

Other names 1

  • Valderrama Orthodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1861877102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 WILDWOOD DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401506",
            "telephone_number": "904-434-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 JORDAN BLASS DR STE 102",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401325",
            "telephone_number": "321-544-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATALIA VALDERRAMA, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "VALDERRAMA DOUGHERTY",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "904-434-7783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN19651",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": "DN19651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valderrama Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 28, 2015; 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.