Melanie E. White, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5601-015 Issued in WI

Practice address

39 W Church St
Evansville, WI 53536-1329

Phone

(608) 882-4860

Fax

(608) 882-4862

NPI assigned

Jan 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Line Dentistry

  • Dental Clinic/Center
  • Evansville, WI
  • NPI 1144132101
  NPD (past)

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164574992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 W CHURCH ST",
            "address_2": "P.O. BOX 175",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361329",
            "telephone_number": "608-882-4860",
            "fax_number": "608-882-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 W CHURCH ST",
            "city": "EVANSVILLE",
            "state": "WI",
            "postal_code": "535361329",
            "telephone_number": "608-882-4860",
            "fax_number": "608-882-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MELANIE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5601-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen Thalacker
• The Grove Family Dental and TMJ Clinic, LLC
• Abbey Tway
• Uro GYN Health Services, LLC
• Austin Henry Westra
• Samuel C White, MD
• Margaret B Wieser, DMD
• Logan James Wilberding, COTA
• Wilke Chiropractic Office SC
• Peter J Wilke, DC

• General Practice Dentistry in Evansville, WI
• Providers in Evansville, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.