MARYAM BRAZDO, DMD, PA
NPI 1295000339
Dentist - General Practice in Melbourne, FL

Active since March 21, 2012
1061 S WICKHAM RD, MELBOURNE, FL 32904(321) 724-1400 Get Directions Write a Review

NPPES record last updated: March 21, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Maryam Brazdo, Dmd, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYAM BRAZDO, DMD, PA (NPI 1295000339) is a healthcare organization registered as a general practice in Melbourne, Florida and active in the NPI registry since March 2012. The organization lists Maryam Brazdo, President, as its authorized official.

NPPES Registry Identity

NPI1295000339
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMARYAM BRAZDO, DMD, PA
Location Address1061 S WICKHAM RDMelbourne, FL 32904-1652
Mailing Address1061 S Wickham RdMelbourne, FL 32904-1652 · (321) 724-1400
Organization SubpartNo
Authorized OfficialMaryam BrazdoPresident · (321) 243-2030
Enumeration DateMarch 21, 2012
NPI 1295000339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in FL · DN18392
Definition

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.

1061 S WICKHAM RD, Melbourne, FL 32904

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
1061 S WICKHAM RD
WEST MELBOURNE, FL 32904
Dentist
1061 S WICKHAM RD
MELBOURNE, FL 32904

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295000339, enumerated as an "organization" on March 21, 2012.

The provider is located at 1061 S WICKHAM RD MELBOURNE, FL 32904 and the phone number is (321) 724-1400.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.