Melissa Jean McColloch, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11759 Issued in MN

Practice address

2210 N Broadway
Rochester, MN 55906-4009

Phone

(507) 288-7379

Fax

(507) 288-9530

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063435626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 N BROADWAY",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064009",
            "telephone_number": "507-288-7379",
            "fax_number": "507-288-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 N BROADWAY",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559064009",
            "telephone_number": "507-288-7379",
            "fax_number": "507-288-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOCH",
        "first_name": "MELISSA",
        "middle_name": "JEAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane M McClintock, CRNA
• Kevin McClure, LMFT
• Natalie Ann McClure, MD
• Rebecca F McClure, M.D.
• Carmen Christine McColley
• Christina Lynn McCollough, DPT
• Jennifer Ann McCombe, MD, MPH, FRCPC
• Laura McConahey
• Megan McConkey
• Michael Robert McConnell, MPAS, PA-C

• General Practice Dentistry in Rochester, MN
• Providers in Rochester, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.