Active NPI
Melissa Jane Maddox, RDH
- Dental Hygienist
- Fort Irwin, CA
National Provider Identifier
1194197327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 28438
- Practice address
- 171 Inner Loop Rd
Fort Irwin, CA 92310 - Phone
- (999) 999-9999
- NPI assigned
- Oct 27, 2015
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 28438 | CA | Primary |
Addresses
Primary practice location
171 Inner Loop Rd
Fort Irwin, CA 92310
Mailing address
171 Inner Loop Rd
Fort Irwin, CA 92310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28384 | Other | CA | REGISTERED DENTAL HYGIENE LICENSE |
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 |
|---|---|---|---|
| 28438 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652745600000",
"number": "1194197327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 INNER LOOP RD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "171 INNER LOOP RD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDOX",
"first_name": "MELISSA",
"middle_name": "JANE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-27",
"last_updated": "2022-05-17",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "28438",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED DENTAL HYGIENE LICENSE",
"identifier": "28384",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.