Active NPI
Melody Miller Richardson, DDS
- Dentist
- Peru, IN
National Provider Identifier
1164500377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12009144A
- Practice address
- 63 West 6TH St
Peru, IN 46970-2134 - Phone
- (765) 473-4109
- NPI assigned
- Nov 2, 2006
- Reactivated
- Oct 22, 2021
- 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 | 12009144A | IN | Primary |
Addresses
Primary practice location
63 West 6TH St
Peru, IN 46970-2134
Mailing address
63 West Sixth St
Peru, IN 46970-2134
Phone (765) 473-4109
Other names 1
- Melody Miller Richardson
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634860800000",
"number": "1164500377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 WEST SIXTH ST",
"city": "PERU",
"state": "IN",
"postal_code": "469702134",
"telephone_number": "765-473-4109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "63 WEST 6TH ST",
"city": "PERU",
"state": "IN",
"postal_code": "469702134",
"telephone_number": "765-473-4109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "MELODY",
"middle_name": "MILLER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2021-10-22",
"certification_date": "2021-10-22",
"deactivation_date": "2021-10-22",
"reactivation_date": "2021-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12009144A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELODY",
"last_name": "RICHARDSON",
"middle_name": "MILLER",
"credential": "DDS PC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Peru, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.