MEDICARE: DR. MELVYN WEINSTOCK D.D.S.,PHD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN 9925	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194734293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVYN WEINSTOCK D.D.S.,PHD.

Provider Business Mailing Address
First Line	:	8588 STARKEY RD
Second Line	:	STE C
City	:	LARGO
State	:	FL
Zip	:	33777-2831
Country	:	US
Telephone Number	:	727-392-7734
Fax Number	:

Provider Business Practice Location Address
First Line	:	8588 STARKEY RD
Second Line	:	STE C
City	:	LARGO
State	:	FL
Zip	:	33777-2831
Country	:	US
Telephone Number	:	727-392-7734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/09/2007

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