Active NPI
Susan Leah Melton, RDH
- Dental Hygienist
- Maryville, TN
National Provider Identifier
1194361261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH2761
- Practice address
- 811 High St
Maryville, TN 37804-5030 - Phone
- (865) 982-2421
- NPI assigned
- Nov 22, 2019
- 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 | DH2761 | TN | Primary |
Addresses
Primary practice location
811 High St
Maryville, TN 37804-5030
Mailing address
5320 Custis LN
Knoxville, TN 37920-3773
Phone (865) 789-2081
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DH2761 | Other | TN | 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 |
|---|---|---|---|
| DH2761 | TN | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574380800000",
"number": "1194361261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5320 CUSTIS LN",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379203773",
"telephone_number": "865-789-2081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "811 HIGH ST",
"city": "MARYVILLE",
"state": "TN",
"postal_code": "378045030",
"telephone_number": "865-982-2421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTON",
"first_name": "SUSAN",
"middle_name": "LEAH",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-22",
"last_updated": "2019-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TN",
"license": "DH2761",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL HYGIENE LICENSE",
"identifier": "DH2761",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maryville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.