Healthcare Provider Details

I. General information

NPI: 1265086060
Provider Name (Legal Business Name): MELANIE KUCHARSKI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 SW 8TH ST STE 201
MIAMI FL
33135-3028
US

IV. Provider business mailing address

1825 NW 167TH ST
MIAMI GARDENS FL
33056-4838
US

V. Phone/Fax

Practice location:
  • Phone: 305-428-2878
  • Fax: 305-428-2316
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN24153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: