Philip R Melnick, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

29627 Issued in CA

Practice address

4281 Katella Ave
#112
Los Alamitos, CA 90720-3500

Phone

(562) 860-1611

NPI assigned

Jan 18, 2013

Last updated

Jan 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1184962524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4281 KATELLA AVE",
            "address_2": "#112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203500",
            "telephone_number": "562-860-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4281 KATELLA AVE",
            "address_2": "#112",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203500",
            "telephone_number": "562-860-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELNICK",
        "first_name": "PHILIP",
        "middle_name": "R",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "29627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gary Paul Mendoza, MA, LMFT

• Periodontics in Los Alamitos, CA
• Providers in Los Alamitos, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.