Individual provider Active NPI

Melissa Elliott Wood, D.D.S

  • General Practice Dentistry
  • Baltimore, MD
National Provider Identifier
1144567900
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15237 Issued in MD
Practice address
4 Reservoir Cir Ste 100
Baltimore, MD 21208-6360
Phone
(410) 484-5800
NPI assigned
Jan 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15237 MD Primary

Addresses

Primary practice location

4 Reservoir Cir Ste 100
Baltimore, MD 21208-6360

Mailing address

11809 Sherbourne Dr
Timonium, MD 21093-1822
Phone (443) 465-6764

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Aug 18, 2015 through Aug 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15237MDMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ed Lazer DDS PC General Practice Past 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": "1358035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1144567900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11809 SHERBOURNE DR",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210931822",
            "telephone_number": "443-465-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 RESERVOIR CIR STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212086360",
            "telephone_number": "410-484-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "MELISSA",
        "middle_name": "ELLIOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-13",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "15237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.