DR. EDWARD SALVATORE MORTELLARO JR. (NPI# 1194068544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194068544 |
| Entity Type | Individual |
| Full Name | DR. EDWARD SALVATORE MORTELLARO JR. |
| Credential | DMD |
| Practice Address |
710 Oakfield Dr Suite 126 Brandon FL 33511-4938 |
| Practice Telephone | 8136857733 |
| Practice Fax Number | 8136819723 |
| Mailing Telephone | 8136857733 |
| Mailing Fax Number | 8136819723 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2013-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN 8061 | FL | Dental Providers |
| Street Address |
710 OAKFIELD DR SUITE 126 |
| City | BRANDON |
| State | FL |
| Zip Code | 33511-4938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112909 | Troy P Noonan | Specialist | 710 Oakfield Dr, Ste 261, Brandon, FL 33511-4937 | 2005-05-24 |
| 1063054310 | Clarke Counseling and Psychological Services | Psychologist | 710 Oakfield Dr, Brandon, FL 33511-4938 | 2019-10-08 |
| 1487109831 | Ray of Sunshine Empowerment Services LLC | Social Worker | 710 Oakfield Dr, Suite 210, Brandon, FL 33511-4938 | 2016-08-15 |
| 1194116053 | Mainstay Home Health LLC | Home Health | 710 Oakfield Dr, Ste 263, Brandon, FL 33511-4938 | 2015-02-13 |
| 1386993947 | Suncoast Community Health Centers, Inc | Clinic/Center | 710 Oakfield Dr, Suite 105, Brandon, FL 33511-4938 | 2012-08-29 |
| 1184918526 | Acupuncture and Natural Medicine LLC | Acupuncturist | 710 Oakfield Dr, Suite 204, Brandon, FL 33511-4938 | 2011-06-02 |
| 1952633851 | Elsa Marie Oben | Psychologist | 710 Oakfield Dr, Suite 153, Brandon, FL 33511-4938 | 2010-02-03 |
| 1174728869 | Erin Marie Smith | Psychologist | 710 Oakfield Dr, Suite 159, Brandon, FL 33511-4938 | 2007-06-20 |
| 1184796138 | Nicholas F Colmenares I | Dentist | 710 Oakfield Dr, Ste 105, Brandon, FL 33511 | 2006-11-14 |
| 1366535767 | Mary A Rutherford | Social Worker | 710 Oakfield Dr, Suite 159, Brandon, FL 33511-4938 | 2006-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
| 1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
| 1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
| 1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
| 1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
| 1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
| 1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
| 1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
| Find all providers in zip 33511 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770700437 | Edward S Mortellaro Jr Dmd Pa | Dentist | 710 Oakfield Drive, Suite 126, Brandon, FL 33511-4907 | 2007-04-20 |
| 1407877400 | Douglas C Wendt Jr. | Dentist | 268 S Moon Ave, Brandon, FL 33511-5711 | 2006-07-22 |
| 1699769208 | Steven L Bartel | Dentist | Psc 41, Box 4488, Brandon, SUFFOLK 09464 | 2005-09-09 |
| 1245499334 | Ruben Fernando Mesia | Dentist | 1327 Providence Rd, Brandon, FL 33511-4885 | 2008-06-04 |
| 1922139294 | Douglas C Wendt, Jr., D.d.s. | Dentist | 268 S Moon Ave, Brandon, FL 33511-5711 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344354 | Philipkjosephsllc | Dentist | 161 Monterey Bay Dr, Boynton Beach, FL 33426-8438 | 2020-10-21 |
| 1194322651 | Peter Tsambazis Dmd, Inc | Dentist | 6654 Collier Blvd Unit 104, Naples, FL 34114-8179 | 2020-10-07 |
| 1265041578 | Lauren Elise Steinberg | Dentist | 7301 W Palmetto Park Rd Ste 303a, Boca Raton, FL 33433-3458 | 2020-07-23 |
| 1306462213 | Miami Healthy Smiles | Dentist | 8861 Sw 69th Ct, Pinecrest, FL 33156-1605 | 2020-06-17 |
| 1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
| 1437785847 | Modern Dental Cape Coral Pllc | Dentist | 706 Sw Pine Island Rd, Suite 103, Cape Coral, FL 33991 | 2020-03-17 |
| 1437783792 | Anthony Joseph Michelotti | Dentist | 3331 Briarwood Cir, Safety Harbor, FL 34695-4691 | 2020-02-26 |
| 1417595893 | Park Plaza Dental Care | Dentist | 1144 N Federal Hwy, Pompano Beach, FL 33062-4322 | 2019-12-16 |
| 1619538832 | George Edward Tolson V | Dentist | 1739 E Commercial Blvd, Oakland Park, FL 33334-5737 | 2019-06-27 |
| 1396203485 | Michael Steven Liss | Dentist | 2600 N Military Trl Ste 310, Boca Raton, FL 33431-6315 | 2019-03-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.