Active NPI
Melanie Thomas
- Dentist
- Davenport, FL
National Provider Identifier
1912759846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN29678
- Practice address
- 2390 North Blvd W Ste C
Davenport, FL 33837-8982 - Phone
- (863) 213-5807
- NPI assigned
- Apr 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN29678 | FL | Primary |
Addresses
Primary practice location
2390 North Blvd W Ste C
Davenport, FL 33837-8982
Mailing address
2390 North Blvd W Ste C
Davenport, FL 33837-8982
Phone (863) 213-5807
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 |
|---|---|---|---|
| DN29678 | FL | MD | Dentist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1912759846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2390 NORTH BLVD W STE C",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338378982",
"telephone_number": "863-213-5807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2390 NORTH BLVD W STE C",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338378982",
"telephone_number": "863-213-5807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "MELANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-03",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN29678",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.