NPIMap

Organization Active NPI

W. David Melevsky, DDS

  • General Practice Dentistry
  • South Portland, ME
National Provider Identifier
1124232772
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4009 Issued in ME
Legal business name
W. DAVID MELEVSKY, DDS
Practice address
25 Long Creek Dr
South Portland, ME 04106-2440
Phone
(207) 761-6699
Fax
(207) 761-0245
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Walter David Melevsky, DDS
Title
Doctor
Phone
(207) 761-6699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 4009 ME Primary

Addresses

Primary practice location

25 Long Creek Dr
South Portland, ME 04106-2440

Mailing address

25 Long Creek Dr
South Portland, ME 04106-2440
Phone (207) 761-6699

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124232772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LONG CREEK DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062440",
            "telephone_number": "207-761-6699",
            "fax_number": "207-761-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LONG CREEK DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062440",
            "telephone_number": "207-761-6699",
            "fax_number": "207-761-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. DAVID MELEVSKY, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELEVSKY",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "207-761-6699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "4009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.