Individual provider Active NPI

Melissa Lauron Dixon

  • Dentist
  • Salem, OR
National Provider Identifier
1043660079
Registry record updated Mar 19, 2021
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10446 Issued in OR
Practice address
255 Lancaster Dr NE
Salem, OR 97301-5155
Phone
(503) 576-8350
Fax
(503) 364-0775
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN21856 FL
Dentist 122300000X D10446 OR Primary

Addresses

Primary practice location

255 Lancaster Dr NE
Salem, OR 97301-5155

Mailing address

255 Lancaster Dr NE
Salem, OR 97301-5155
Phone (503) 576-8350

Other names 1

  • Melissalynn Lauron Dixon Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlaurondixon15479@yvfwc.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170407001970 OR Order and Referring Only - DentistPractitioner - Dentist 0244516185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21856FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1043660079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015155",
            "telephone_number": "503-576-8350",
            "fax_number": "503-364-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015155",
            "telephone_number": "503-576-8350",
            "fax_number": "503-364-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURON DIXON",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21856",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlaurondixon15479@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "255 Lancaster Dr NE",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973015155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSALYNN",
            "last_name": "DIXON",
            "middle_name": "LAURON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.