Individual provider Active NPI

Melissa Huang

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1023671484
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1002455 Issued in WI
Practice address
5542 W Fond Du Lac Ave
Milwaukee, WI 53216-1200
Phone
(414) 240-0935
NPI assigned
Apr 20, 2019
Last updated
Nov 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1002455 WI Primary

Addresses

Primary practice location

5542 W Fond Du Lac Ave
Milwaukee, WI 53216-1200

Mailing address

5542 W Fond Du Lac Ave
Milwaukee, WI 53216-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191025000945 NY Order and Referring Only - DentistPractitioner - Dentist 9830421718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002455WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
True Dental LLC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1023671484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5542 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5542 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532161200",
            "telephone_number": "414-240-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-20",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.