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General NPI Number Information
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NPI Number | 1871488395
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Entity Type | Individual
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Provider Name | ILLYSSA JARAPLASAN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/12/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 5484 LORKEY LN
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City | MELBOURNE
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State | FL
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Zip | 32940-8731
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Country | US
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Telephone | 321-837-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 5384 LORKEY LANE #101
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City | VIERA
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State | FL
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Zip | 32940-8731
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Country | US
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Telephone | 321-837-3700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN30448
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License Number State | FL
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