Active NPI
Melvin Dale Newcomb, DDS
- Dentist
- Virginia, MN
National Provider Identifier
1154484699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- Practice address
- 216 N 5TH Ave
Virginia, MN 55792 - Phone
- (218) 749-8908
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | MN | Primary |
Addresses
Primary practice location
216 N 5TH Ave
Virginia, MN 55792
Mailing address
4416 Lakeside Dr
Eveleth, MN 55734
Phone (218) 749-8908
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 |
|---|---|---|---|
| 122300000X | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mesabi Dental Service | Dentist | 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.
-
- Dentist
- Virginia, MN
- NPI 1922109800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1154484699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4416 LAKESIDE DR",
"city": "EVELETH",
"state": "MN",
"postal_code": "55734",
"telephone_number": "218-749-8908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 N 5TH AVE",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "55792",
"telephone_number": "218-749-8908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWCOMB",
"first_name": "MELVIN",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.