Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730630633 Individual Practitioner Female Practitioner

Dr. Mary Baddour , DDS

Dentist - General Practice • Melbourne, FL

Professional Overview & Biography Verified Profile Summary

Dr. Mary Baddour, DDS is a registered healthcare professional specializing in Dentist - General Practice in Melbourne, FL. Practice services are available at 2120 SARNO RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2120 Sarno Rd

Melbourne, FL 329353084

Telephone 3212416800
Fax 3212416890
Associated Practice Facility / Clinic
🏢 Brevard Health Alliance Inc Facility NPI 1013355726

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Melbourne, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
84 Specialists

Practicing in Melbourne, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-08-08
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN22332

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License NM DD4616

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
109040300 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013347277

Doctor of Psychology (Psy.D.)

Christy Powell , APRN

Nurse Practitioner - Family

NPI 1013481050

Advanced Practice Registered Nurse

Dr. Lindsay Rule , DMD

Dentist - General Practice

NPI 1033471255

Doctor of Dental Medicine

Jessica Regan , PA

Physician Assistant

NPI 1033592597

Physician Assistant

Vimari De La Cruz , ARNP, FNP-C

Nurse Practitioner - Family

NPI 1033795760

Advanced Registered Nurse Practitioner, Family Nurse Practitioner (Certified)

Meagan Sumner , PA-C

Physician Assistant

NPI 1043084254

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2024

Dentist (License #DN22332 in FL)

📍
Updated Practice Location April 25, 2022

Registered at 2120 SARNO RD, MELBOURNE, FL 329353084 (Tel: 3212416800)

📍
Updated Business Mailing Address April 25, 2022

Registered at PO BOX 1137, MELBOURNE, FL 329021137 (Tel: 3219529696)

📍
Updated Practice Location August 29, 2018

Registered at 510 E LISA DR, CHAPARRAL, NM 88081 (Tel: 5758240128)

👤
Provider Name / Credentials Updated August 29, 2018

Recorded as MARY BADDOUR, DDS

NPI Profile Active October 17, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 17, 2016

Registered at 510 E LISA DR, CHAPARRAL, NM 880817809 (Tel: 5758240128)

📍
Updated Business Mailing Address October 17, 2016

Registered at 385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 880053423 (Tel: 5755261105)

👤
Provider Name / Credentials Updated October 17, 2016

Recorded as MARY BADDOUR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 17, 2016

Dentist (License #DD4616 in NM)

🟢
Initial NPI Registration & Enumeration October 17, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730630633
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 17, 2016
Last Update: August 08, 2024
Sole Proprietor: No

Mailing Address

Po Box 1137

Melbourne, FL 329021137

Phone: 3219529696

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.