NEW IMAGE DENTISTY OF PALM BAY (NPI# 1285047506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285047506 |
| Entity Type | Organization |
| Organization Name | NEW IMAGE DENTISTY OF PALM BAY |
| Practice Address |
3590 Bayside Lakes Blvd Se Palm Bay FL 32909-6866 |
| Practice Telephone | 3219840044 |
| Practice Fax Number | 3219840707 |
| Mailing Telephone | 3219840044 |
| Mailing Fax Number | 3219840707 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |
| Authorized Official Name | MOHAMMED MUJEEB (OWNER) |
| Authorized Official Telephone | 3214344444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DN19771 | FL | Dental Providers |
| Street Address |
3590 BAYSIDE LAKES BLVD SE |
| City | PALM BAY |
| State | FL |
| Zip Code | 32909-6866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609353713 | Tara Derakhshandeh | Dentist | 3590 Bayside Lakes Blvd Se, Palm Bay, FL 32909 | 2018-07-20 |
| 1679002604 | Lina Alejandra Ramirez | Dentist | 3590 Bayside Lakes Blvd Se, Palm Bay, FL 32909-6866 | 2017-06-04 |
| 1881075760 | Farid Mastali | Dentist | 3590 Bayside Lakes Blvd Se, Palm Bay, FL 32909-6866 | 2015-06-16 |
| 1063828218 | Kasim Manzur | Dentist | 3590 Bayside Lakes Blvd Se, Palm Bay, FL 32909-6866 | 2014-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447349 | Sarah Nicosia | Registered Nurse | 2752 Palisades Dr, Palm Bay, FL 32909 | 2020-08-12 |
| 1447881297 | Shangri-la of Palm Bay Alf, LLC | Assisted Living Facility | 3604 Jupiter Blvd. Se, Palm Bay, FL 32909 | 2020-01-30 |
| 1972094357 | Mindful Counseling and Wellness LLC | Social Worker | 221 Devlin Ct Se, Palm Bay, FL 32909 | 2018-05-22 |
| 1306348859 | Mallory Kathleen Herndon | Behavior Technician | 458 Barcelona Rd, Palm Bay, FL 32909 | 2018-03-01 |
| 1548786627 | Chotsani Merrill | Home Health Aide | 781 Davenport St Se, Palm Bay, FL 32909 | 2017-08-21 |
| 1639629538 | Maggie Cameron | Clinic/Center | 2511 Quentin Ave Ne, Palm Bay, FL 32909 | 2016-10-04 |
| 1194195016 | Dawn Goodwin | Pharmacist | 3450 Bayside Lakes Shopping Center, Palm Bay, FL 32909 | 2015-10-05 |
| 1124407796 | Jorge Ortiz | Physical Therapist | 470 Malabar Rd Se, Ste 102, Palm Bay, FL 32909 | 2015-05-28 |
| 1932506227 | Annalisa Tietjen I | Dental Hygienist | 714 Ave C, Fort Pierce, FL 32909 | 2014-12-02 |
| 1194147611 | Carl Glenmore Morrison Sr. | General Practice | 2125 Windbrook Drive, Palm Bay, FL 32909 | 2014-01-17 |
| Find all providers in zip 32909 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517077 | Professional Dental Alliance of Palm Bay Palm Bay Rd, Pllc | Dentist | 1890 Palm Bay Rd Ne Ste 2, Palm Bay, FL 32905-3071 | 2019-09-17 |
| 1528547353 | Professional Dental Alliance of Minton, Pllc | Dentist | 5132 Minton Rd Nw Ste A, Palm Bay, FL 32907-1110 | 2018-08-13 |
| 1942650155 | Karan Doomra | Dentist | 3590 Bayside Lakes Blvd Se Ste 1, Palm Bay, FL 32909-6866 | 2016-06-18 |
| 1558602169 | Subhash G Rege | Dentist | 1764 Palm Bay Rd Ne, Palm Bay, FL 32905-2904 | 2013-03-06 |
| 1083974901 | Liliana Marshall Dmd Pllc | Dentist | 2186 Harris Ave Ne Ste 3, Palm Bay, FL 32905-4044 | 2012-05-24 |
| 1457628505 | Paula Fiuza Bielak | Dentist | 5132 Minton Rd Nw Ste I, Palm Bay, FL 32907-1110 | 2011-11-17 |
| 1851611669 | Eva Maria Napoles Rodriguez | Dentist | 1421 Malabar Rd Ne Ste 240, Palm Bay, FL 32907-2559 | 2010-06-03 |
| 1679703185 | Curtis B. Hill, Jr., Dmd, Pa | Dentist | 1400 Palm Bay Rd Ne, Ste A, Palm Bay, FL 32905-3851 | 2009-07-17 |
| 1962615716 | Theresa A Yasonis | Dentist | 730 Emerson Dr Ne, Palm Bay, FL 32907-1430 | 2007-05-08 |
| 1912086034 | Kenneth M Yip-young | Dentist | 3440 Bayside Lakes Blvd Se, Suite 1, Palm Bay, FL 32909-6843 | 2006-11-02 |
| Find all providers in PALM BAY | ||||
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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.