Mellard Dentistry at Leon Springs

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13920 Issued in TX

Legal business name

MELLARD DENTISTRY AT LEON SPRINGS

Practice address

24200 W Ih 10
Suite 112
San Antonio, TX 78257-1145

Phone

(210) 687-1133

Fax

(210) 687-1132

NPI assigned

Feb 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mary Mellard, DDS

Title

President

Phone

(210) 687-1133

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1205168473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 W IH 10",
            "address_2": "SUITE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571145",
            "telephone_number": "210-687-1133",
            "fax_number": "210-687-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 W IH 10",
            "address_2": "SUITE 112",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571145",
            "telephone_number": "210-687-1133",
            "fax_number": "210-687-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELLARD DENTISTRY AT LEON SPRINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "MELLARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-687-1133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13920",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "13919",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huong Le Melkon, MPT
• Ana Mariel Mella-Davila, MSN, RN
• Kimberly A Mella, NNP
• Sergio Mellado Flores, MD
• Wynne Elaine Melland, LPC
• Mary V Mellard, DDS
• Nathan Simon Mellenbruch
• Amelia M Mellett Keith, DVM
• Rachelle Renee Mellieon, LPC
• Kira S Mello Rogers, PSYD

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.