Individual provider Active NPI

Melanie Ann Richardson, DDS

  • Dentist
  • Santa Monica, CA
National Provider Identifier
1063713949
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59247 Issued in CA
Practice address
3201 Wilshire Blvd
#110
Santa Monica, CA 90403-2344
Phone
(877) 227-9892
NPI assigned
Nov 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 59247 CA Primary

Addresses

Primary practice location

3201 Wilshire Blvd
#110
Santa Monica, CA 90403-2344

Mailing address

3201 Wilshire Blvd Ste 110
Santa Monica, CA 90403-2335
Phone (310) 829-5181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
59247CAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Dental Health PC Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1063713949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD STE 110",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032335",
            "telephone_number": "310-829-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD",
            "address_2": "#110",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032344",
            "telephone_number": "877-227-9892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "MELANIE",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-09",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.