Active NPI
Michael Allan Mehlhoff, D.D.S.
- Dentist
- Moline, IL
National Provider Identifier
1285037150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019030059
- Practice address
- 106 19TH Ave
Suite 90
Moline, IL 61265-3700 - Phone
- (309) 277-6567
- NPI assigned
- Oct 6, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019030059 | IL | Primary |
| Dentist | 122300000X | DDS-09120 | IA |
Addresses
Primary practice location
106 19TH Ave
Suite 90
Moline, IL 61265-3700
Mailing address
106 19TH Ave
Suite 90
Moline, IL 61265-3700
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 |
|---|---|---|---|
| DDS-09120 | IA | MD | Dentist |
| 019030059 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1285037150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 19TH AVE",
"address_2": "SUITE 90",
"city": "MOLINE",
"state": "IL",
"postal_code": "612653700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 19TH AVE",
"address_2": "SUITE 90",
"city": "MOLINE",
"state": "IL",
"postal_code": "612653700",
"telephone_number": "309-277-6567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHLHOFF",
"first_name": "MICHAEL",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-06",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019030059",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09120",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.