New Image Dentistry of Palm Bay Road, Inc

Primary specialty

DentistTaxonomy code 122300000X

License

DN21355 Issued in FL

Legal business name

NEW IMAGE DENTISTRY OF PALM BAY ROAD, INC

Practice address

1764 Palm Bay Rd NE
Palm Bay, FL 32905-2904

Phone

(321) 725-5512

Fax

(321) 725-5592

NPI assigned

Jan 18, 2017

Organization subpart

No

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

Authorized official

Name

Mohammed Mujeeb

Title

Owner/Dentist

Phone

(321) 536-0157

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1484697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1952847774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 PALM BAY RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052904",
            "telephone_number": "321-725-5512",
            "fax_number": "321-725-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1764 PALM BAY RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052904",
            "telephone_number": "321-725-5512",
            "fax_number": "321-725-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW IMAGE DENTISTRY OF PALM BAY ROAD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-18",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "MUJEEB",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "321-536-0157"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Nelson, APRN
• Nemours Children's Health, Palm Bay, Primary Care
• New Beginning Board and Care Home
• New Beginning Care Home
• New Horizonrehab (Sena G Mortey)
• New Image Dentistry on Minton
• New Image Dentisty of Palm Bay
• New Path Behavior Analysis, LLC
• New Way Counseling Services Inc.
• Nextgen Pathology

• Dentist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.