Active NPI
Shamiram Aodisho Melko, DDS
- Dentist
- Mountain View, CA
National Provider Identifier
1134435811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59565
- Practice address
- 100 W El Camino Real Ste 74a
Mountain View, CA 94040-2649 - Phone
- (650) 961-5975
- Fax
- (650) 961-5975
- NPI assigned
- Aug 19, 2010
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 59565 | CA | Primary |
Addresses
Primary practice location
100 W El Camino Real Ste 74a
Mountain View, CA 94040-2649
Mailing address
2413 Temescal Dr
Modesto, CA 95355-9258
Phone (209) 450-5175
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 |
|---|---|---|---|
| 59565 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melko Dental Group | Current | Accepting new patients |
Locations
100 W El Camino Real
Ste 74A
Mountain View, CA 94040
Phone (650) 961-5975
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.
-
- Dental Clinic/Center
- Mountain View, CA
- NPI 1265971600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614643200000",
"number": "1134435811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 TEMESCAL DR",
"city": "MODESTO",
"state": "CA",
"postal_code": "953559258",
"telephone_number": "209-450-5175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W EL CAMINO REAL STE 74A",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940402649",
"telephone_number": "650-961-5975",
"fax_number": "650-961-5975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELKO",
"first_name": "SHAMIRAM",
"middle_name": "AODISHO",
"name_prefix": "Mrs.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-19",
"last_updated": "2021-03-02",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.