Active NPI
Melissa Bailey
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Ramon, CA
National Provider Identifier
1063761609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 61237
- Practice address
- 11040 Bollinger Canyon Rd Ste K
San Ramon, CA 94582-5056 - Phone
- (925) 648-8588
- NPI assigned
- Aug 29, 2012
- Last updated
- Jan 31, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 61237 | CA | Primary |
Addresses
Primary practice location
11040 Bollinger Canyon Rd Ste K
San Ramon, CA 94582-5056
Mailing address
5424 Sunol Blvd Ste 10-433
Pleasanton, CA 94566-7705
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61237 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Interoperability endpoints
- mbailey@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643587200000",
"number": "1063761609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5424 SUNOL BLVD STE 10-433",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945667705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11040 BOLLINGER CANYON RD STE K",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825056",
"telephone_number": "925-648-8588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAILEY",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2022-01-31",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "61237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Ramon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.