Dentist Providers In Palm Bay, Florida

Search Dentist NPI records in Palm Bay, FL

Search or browse through the NPI records of dentist registered healthcare providers with a business address in Palm Bay, FL. The listings include accepted insurance information, Medicare acceptance status, and PECOS enrollment data. The total number of NPI records is 70, of which 24 are registered as organizations and 46 as individuals. A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

66% Individuals

34% Organizations

27% Female

39% Male

66% Individual Providers (46)34% Medical Organizations (24)27% Female Providers (19)39% Male Providers (27)

Map of Providers

We have mapped the Dentist providers in Palm Bay, FL to visually represent the practice location of each individual or organization. Click on any of the the pins to see the provider details at that location.

List of Providers

Table of Dentist NPI Profiles in Palm Bay, FL
NPI	Name	Address	Insurance	Medicare	PECOS
1013093491	LILIANA MERCEDES MARSHALL (Individual)	2186 HARRIS AVE NE SUITE 3 PALM BAY, FL 32905 (321) 723-2620	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	YES
1023499431	COURTNEY SEVILLA (Individual)	3420 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 722-0155	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	YES
1043573397	HIRAL MUKUNDKUMAR MODI (Individual)	1764 PALM BAY RD NE PALM BAY, FL 32905 (321) 725-5512	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1063487155	SYED Z QUADRI (Individual)	2090 PALM BAY RD NE PALM BAY, FL 32905 (321) 984-2255	Aetna CVS Health Ambetter Health Ambetter of Alabama Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1063826170	NEW IMAGE DENTISTRY ON MINTON (Organization)	5132 MINTON RD NW STE 1 PALM BAY, FL 32907 (321) 725-9595		Non-Participating Provider	NO
1063828218	KASIM MANZUR (Individual)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 984-0044	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1073137303	MHD FADI ALHAWASLI (Individual)	6050 BABCOCK ST SE STE 2 PALM BAY, FL 32909 (321) 725-9946	Cigna Healthcare Delta Dental Guardian	Non-Participating Provider	NO
1083974901	LILIANA MARSHALL DMD PLLC (Organization)	2186 HARRIS AVE NE STE 3 PALM BAY, FL 32905 (321) 723-2620		Non-Participating Provider	NO
1124188420	MARK ANDREW FIGURA (Individual)	2105 PALM BAY RD NE SUITE #4-5W PALM BAY, FL 32905 (321) 725-7644	Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian	Non-Participating Provider	YES
1154439628	ATM N AMIN (Individual)	1890 PALM BAY RD NE SUITE 2 PALM BAY, FL 32905 (321) 724-5100	Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian	Non-Participating Provider	NO
1174284806	CDPG, P.A. RIVER BREEZE DENTAL CARE (Organization)	5201 BABCOCK ST NE STE 4 PALM BAY, FL 32905 (321) 722-4400	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1174803340	RONALD GENE LIST (Individual)	1460 BAYTREE DR NE PALM BAY, FL 32905 (321) 914-0915		Non-Participating Provider	NO
1194943084	DR MARK S COICAN PA (Organization)	2179 JULIAN AVE NE SUITE 2 PALM BAY, FL 32905 (321) 723-8727		Non-Participating Provider	NO
1215611967	JESSICA ANN NGUYEN (Individual)	3420 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 722-0155	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1225411069	AHMED TAHA (Individual)	6050 BABCOCK ST SE STE 2 PALM BAY, FL 32909 (321) 725-9946	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1265523633	ANDRE JEAN BERUBE (Individual)	5240 BABCOCK ST NE SUITE 205 PALM BAY, FL 32905 (321) 722-2193		Non-Participating Provider	NO
1265704548	ATM AMIN DDS LLC (Organization)	4620 LIPSCOMB ST NE SUITE 2 PALM BAY, FL 32905 (321) 724-5100		Non-Participating Provider	NO
1285047506	NEW IMAGE DENTISTY OF PALM BAY (Organization)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 984-0044		Non-Participating Provider	NO
1285792986	CHARLES A. SARLO (Individual)	5201 BABCOCK ST NE STE 8 PALM BAY, FL 32905 (321) 984-2565		Non-Participating Provider	NO
1306155163	ROBERT WILLARD UNDERILL (Individual)	2156 JULIAN AVE NE PALM BAY, FL 32905 (321) 724-9300		Non-Participating Provider	NO
1326233214	ANDREA ELAINE CUNNINGHAM (Individual)	620 MALABAR RD SE SUITE 3 PALM BAY, FL 32907 (321) 722-2688	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National Humana Paramount Paramount Dental UnitedHealthcare	Non-Participating Provider	NO
1346729167	PROFESSIONAL DENTAL ALLIANCE OF BAYSIDE LAKES, PLLC NEW IMAGE DENTISTRY BAYSIDE LAKES (Organization)	3590 BAYSIDE LAKES BLVD SE STE 1 PALM BAY, FL 32909 (321) 984-0044	Aetna CVS Health Ambetter Health Ambetter of Alabama Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1407414766	HELEN ELIZABETH MAY (Individual)	1890 PALM BAY RD NE PALM BAY, FL 32905 (919) 244-0040	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Dominion National Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1447391321	ELI E. WHITE (Individual)	6050 BABCOCK ST SE SUITE 2 PALM BAY, FL 32909 (321) 725-9946		Non-Participating Provider	NO
1457628505	PAULA FIUZA BIELAK (Individual)	5132 MINTON RD NW STE I PALM BAY, FL 32907 (321) 890-3425	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Guardian Humana	Non-Participating Provider	NO
1518048065	WASIM MICHAEL ASSAF (Individual)	6050 BABCOCK ST SE STE 2 PALM BAY, FL 32909 (321) 725-9946	Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1518517077	PROFESSIONAL DENTAL ALLIANCE OF PALM BAY PALM BAY RD, PLLC (Organization)	1890 PALM BAY RD NE STE 2 PALM BAY, FL 32905 (321) 724-5100	Aetna CVS Health Ambetter Health Ambetter of Alabama Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1528547353	PROFESSIONAL DENTAL ALLIANCE OF MINTON, PLLC NEW IMAGE DENTISTRY MINTON (Organization)	5132 MINTON RD NW STE A PALM BAY, FL 32907 (321) 725-9595	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1558602169	SUBHASH G REGE (Individual)	1764 PALM BAY RD NE PALM BAY, FL 32905 (321) 725-5512		Non-Participating Provider	NO
1568473312	PATRICIA BLAKE (Individual)	1421 MALABAR RD NE SUITE 240 PALM BAY, FL 32907 (321) 722-8440	Blue Cross and Blue Shield of Alabama	Non-Participating Provider	NO
1578970091	KRISTINA GALLIGAN (Individual)	1051 PORT MALABAR BLVD NE PALM BAY, FL 32905 (321) 729-6060	Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Dominion National EMI Health Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1588448211	EKOS PALM BAY, PLLC (Organization)	195 MALABAR RD NW STE A-2 PALM BAY, FL 32907 (813) 340-0116	Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1588725816	HENRY L MASON (Individual)	3420 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 722-0155	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	YES
1598983504	MARK STEVEN COICAN (Individual)	2179 JULIAN AVE NE SUITE 2 PALM BAY, FL 32905 (321) 723-8727		Non-Participating Provider	NO
1609353713	TARA DERAKHSHANDEH (Individual)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 984-0044	Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1629282504	LORI DIANNE NELSON (Individual)	730 EMERSON DR. NW PALM BAY, FL 32907 (321) 984-7878	Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1639376825	SWETHA G REDDY (Individual)	190 MALABAR RD SW STE 104 PALM BAY, FL 32907 (321) 914-0080	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1669166575	OCEAN SMILES DENTISTRY LLC (Organization)	2105 PALM BAY RD NE STE 4-5 PALM BAY, FL 32905 (321) 725-7644	Aetna CVS Health UnitedHealthcare	Non-Participating Provider	NO
1669780284	CAPE SIDE DENTAL P A CAPESIDE DENTAL (Organization)	3265 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 727-0011		Non-Participating Provider	NO
1679002604	LINA ALEJANDRA RAMIREZ (Individual)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 544-7036	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental of North Carolina Humana Paramount Paramount Dental Renaissance Dental	Non-Participating Provider	NO
1679703185	CURTIS B. HILL, JR., DMD, PA (Organization)	1400 PALM BAY RD NE STE A PALM BAY, FL 32905 (321) 728-0094		Non-Participating Provider	NO
1679980163	BAYSIDE DENTAL CARE LLC (Organization)	3440 BAYSIDE LAKES BLVD SE SUITE 1 PALM BAY, FL 32909 (321) 726-8884	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1679980163	BAYSIDE DENTAL CARE LLC (Organization)	3440 BAYSIDE LAKES BLVD SE SUITE 1 PALM BAY, FL 32909 (321) 726-8884	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1699893651	DIANE PATRICE JONES (Individual)	4670 LIPSCOMB ST NE SUITE 13 PALM BAY, FL 32905 (321) 724-1343	Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1700436615	GLADYSBEL JIMENEZ (Individual)	5132 MINTON RD NW PALM BAY, FL 32907 (321) 725-9595	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1740592922	CURT SONCHAIWANICH (Individual)	5201 BABCOCK ST NE PALM BAY, FL 32905 (321) 722-4400	Aetna CVS Health Ambetter Health Ambetter of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Humana Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1770062465	PROFESSIONAL DENTAL ALLIANCE OF PALM BAY, PLLC PALM BAY DENTAL CENTER (Organization)	1764 PALM BAY RD NE PALM BAY, FL 32905 (321) 725-5512	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1770224107	SWETHA REDDY & PAVAN KANCHARLA LLC (Organization)	190 MALABAR RD. SUITE 104 PALM BAY, FL 32907 (321) 914-0080		Non-Participating Provider	NO
1770827834	ASSAF, INC (Organization)	6050 BABCOCK ST SE STE 2 PALM BAY, FL 32909 (321) 725-9946	DentaQuest Insurance Company Inc. Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1801028592	LORI D. NELSON DDS, PA (Organization)	730 EMERSON DR. NW PALM BAY, FL 32907 (321) 984-7878		Non-Participating Provider	NO
1821441940	ALEJANDRA GONZALEZ FERGUSON (Individual)	3420 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 722-0155	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	YES
1831396282	JEFFERSON MICHAEL PECORA (Individual)	2105 PALM BAY ROAD NE STE 4-5 PALM BAY, FL 32905 (321) 725-7644	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1831824952	ZAID MUJEEB (Individual)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 984-0044	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1841646213	CURTIS HILL (Individual)	1400 PALM BAY RD STE A PALM BAY, FL 32905 (321) 412-6012	Guardian	Non-Participating Provider	NO
1851611669	EVA MARIA NAPOLES RODRIGUEZ (Individual)	1421 MALABAR RD NE STE 240 PALM BAY, FL 32907 (321) 722-8440	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1861781130	COMFORTABLE CARE DENTAL HEALTH PROFESSIONALS, PA SMILE TODAY DENTISTRY (Organization)	3420 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 292-1313	Aetna CVS Health Ambetter Health Ambetter of Alabama	Non-Participating Provider	NO
1871279109	NENAR BARAZI (Individual)	3440 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 265-4863	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	NO
1881075760	FARID MASTALI (Individual)	3590 BAYSIDE LAKES BLVD SE PALM BAY, FL 32909 (321) 984-0044	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	YES
1891468070	JEREMY PITTMAN (Individual)	2105 PALM BAY RD NE STE 4-5 PALM BAY, FL 32905 (321) 725-7644	Aetna CVS Health Ambetter Health Ambetter of Alabama Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental Renaissance Dental UnitedHealthcare	Non-Participating Provider	YES
1912086034	KENNETH M YIP-YOUNG (Individual)	3440 BAYSIDE LAKES BLVD SE SUITE 1 PALM BAY, FL 32909 (321) 768-0330	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Guardian Humana Paramount Paramount Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1922169788	JACK ROSENKRANTZ (Individual)	1051 PORT MALABAR BLVD NE PALM BAY, FL 32905 (321) 729-6060	Anthem Blue Cross and Blue Shield Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas	Non-Participating Provider	NO
1932276268	PALM BAY DENTAL CENTER PA (Organization)	1764 PALM BAY ROAD NE PALM BAY, FL 32905 (321) 725-5512		Non-Participating Provider	NO
1932642634	ULTIMATE SMILE DESIGN LLC (Organization)	730 EMERSON DR NE PALM BAY, FL 32907 (321) 984-7878		Non-Participating Provider	NO
1942315502	ROBERT W UNDERILL DMD PA (Organization)	2156 JULIA AVE NE PALM BAY, FL 32905 (321) 724-9300		Non-Participating Provider	NO
1942393038	WAYNE W KEARNEY (Individual)	2179 JULIAN AVE NE SUITE 1 PALM BAY, FL 32905 (321) 952-1625	Aetna CVS Health Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Humana Paramount Paramount Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1942650155	KARAN DOOMRA (Individual)	3590 BAYSIDE LAKES BLVD SE STE 1 PALM BAY, FL 32909 (321) 984-0044	Aetna CVS Health Ambetter Health Ambetter of Alabama Anthem Blue Cross and Blue Shield Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Renaissance Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	YES
1952144529	DESTINY FAITH WOLCOTT (Individual)	1890 PALM BAY RD NE STE 2 PALM BAY, FL 32905 (321) 724-5100	Aetna CVS Health Antidote Health Plan of Arizona Inc. Antidote Health Plan of Ohio Inc. BEST Life Blue Cross and Blue Shield of Alabama Cigna Healthcare Delta Dental Dominion National EMI Health Florida Combined Life Guardian Humana Paramount Paramount Dental Solstice Benefits UnitedHealthcare	Non-Participating Provider	NO
1952847774	NEW IMAGE DENTISTRY OF PALM BAY ROAD, INC (Organization)	1764 PALM BAY RD NE PALM BAY, FL 32905 (321) 725-5512		Non-Participating Provider	NO
1952875635	LUIS CARLOS MEJIA (Individual)	620 MALABAR RD SE STE 3 PALM BAY, FL 32907 (786) 622-3950	Aetna CVS Health Blue Cross and Blue Shield of Illinois Blue Cross and Blue Shield of Montana Blue Cross and Blue Shield of Oklahoma Blue Cross and Blue Shield of Texas Delta Dental Florida Combined Life Guardian	Non-Participating Provider	NO
1962615716	THERESA A YASONIS (Individual)	730 EMERSON DR NE PALM BAY, FL 32907 (321) 984-7878		Non-Participating Provider	NO

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