| New Image Maxillofacial Llc | |
|
1325 S Pine St Suite 102 Melbourne FL 32901-3189 | |
| (321) 725-5377 | |
| (321) 951-3393 |
| Full Name | New Image Maxillofacial Llc |
|---|---|
| Speciality | Dentist |
| Location | 1325 S Pine St, Melbourne, Florida |
| Authorized Official Name and Position | Richard W Schmid (MANAGER) |
| Authorized Official Contact | 3217255377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Image Maxillofacial Llc 1325 S Pine St Suite 102 Melbourne FL 32901-3189 Ph: (321) 725-5377 | New Image Maxillofacial Llc 1325 S Pine St Suite 102 Melbourne FL 32901-3189 Ph: (321) 725-5377 |
| NPI Number | 1194767707 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 05/19/2014 |
| Medicare PECOS PAC ID | 6800029331 |
|---|---|
| Medicare Enrollment ID | O20140507000700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194767707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN7413 (Florida) | Primary |
| Provider Name | Richard Schmid |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1740458934 PECOS PAC ID: 1456385103 Enrollment ID: I20050921001125 |
| Provider Name | King Kim |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1639358211 PECOS PAC ID: 9436321874 Enrollment ID: I20111007000466 |
| Provider Name | Zenon Paul Kossak |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1306109475 PECOS PAC ID: 0446558456 Enrollment ID: I20190408001025 |
| Provider Name | Tyler James Banachowski |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033484944 PECOS PAC ID: 0749511830 Enrollment ID: I20220202003057 |
| Provider Name | Travis James Austin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073670550 PECOS PAC ID: 0749401628 Enrollment ID: I20230912001053 |
Clark F. Brown, Jr. Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2113 Sarno Rd, Melbourne, FL 32935 Phone: 321-259-9429 Fax: 321-259-5844 | |
Sedaros Oral Facial Surgery & Dental Implants Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2301 W Eau Gallie Blvd Ste 1, Melbourne, FL 32935 Phone: 321-610-7868 Fax: 321-610-7818 | |
Eley Family Dentistry, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2301 W Eau Gallie Blvd, Suite #102, Melbourne, FL 32935 Phone: 321-622-8711 Fax: 321-622-8712 | |
Joe M Creel, Dds, Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 W New Haven Ave, Melbourne, FL 32901 Phone: 321-723-8821 | |
Sunshine Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 8061 Spyglass Hill Rd, Suite 101, Melbourne, FL 32940 Phone: 321-622-6255 Fax: 321-622-6254 | |
Stephen T. Ruso, D.d.s., M.s., P.l.l.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3760 N Wickham Rd Ste 1, Melbourne, FL 32935 Phone: 321-242-9900 | |
New Image Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7827 N Wickham Rd, Suite A, Melbourne, FL 32940 Phone: 321-434-4444 |