Active NPI
Ali Correa, DDS
- General Practice Dentistry
- Merritt Island, FL
National Provider Identifier
1972815835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN20957
- Practice address
- 229 Crocket Blvd
Merritt Island, FL 32953 - Phone
- (787) 435-3064
- NPI assigned
- Jul 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN20957 | FL | Primary |
Addresses
Primary practice location
229 Crocket Blvd
Merritt Island, FL 32953
Mailing address
8908 Albert Stewart LN
Silver Spring, MD 20910-1901
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 |
|---|---|---|---|
| DN20957 | FL | MD | General Practice Dentistry |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1972815835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8908 ALBERT STEWART LN",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209101901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 CROCKET BLVD",
"city": "MERRITT ISLAND",
"state": "FL",
"postal_code": "32953",
"telephone_number": "787-435-3064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA",
"first_name": "ALI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-08",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN20957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merritt Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.