Healthcare Provider Details

I. General information

NPI: 1164873428
Provider Name (Legal Business Name): MELANIE BUCHANAN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2016
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7055 SE 110TH STREET RD
BELLEVIEW FL
34420-3525
US

IV. Provider business mailing address

4820 SW 48TH AVE UNIT 602
OCALA FL
34474-6307
US

V. Phone/Fax

Practice location:
  • Phone: 352-622-2664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN22114
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: