Individual provider Active NPI

Judy Yudita Melamed, D.D.S.

  • Endodontics
  • Lutherville, MD
National Provider Identifier
1063604718
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
14145 Issued in MD
Practice address
1407 York Rd Ste 210
Lutherville, MD 21093
Phone
(410) 821-5553
Fax
(410) 825-7213
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 14145 MD Primary

Addresses

Primary practice location

1407 York Rd Ste 210
Lutherville, MD 21093

Mailing address

1407 York Rd Ste 210
Lutherville, MD 21093-6042
Phone (410) 821-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20160215001344 MD Order and Referring Only - DentistPractitioner - Dentist 5698079416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14145MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Endodontic Partners LLC Endodontics Current Accepting new patients
Endodontic Partners LLC Endodontics Current Accepting new patients

Locations

1407 York Rd
Ste 210
Timonium, MD 21093
Phone (410) 296-2692

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1063604718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 YORK RD STE 210",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936042",
            "telephone_number": "410-821-5553",
            "fax_number": "410-825-7213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 YORK RD STE 210",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "21093",
            "telephone_number": "410-821-5553",
            "fax_number": "410-825-7213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELAMED",
        "first_name": "JUDY",
        "middle_name": "YUDITA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "14145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

Verify at the official NPI Registry.