Provider Demographics
NPI:1720633282
Name:MERKAJ, VILSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:VILSON
Middle Name:
Last Name:MERKAJ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12536 116TH ST
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-2501
Mailing Address - Country:US
Mailing Address - Phone:313-443-4840
Mailing Address - Fax:
Practice Address - Street 1:12720 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3601
Practice Address - Country:US
Practice Address - Phone:727-581-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600292122300000X
FLDN24839122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist