Active NPI
Roberta Maria Melton, DDS
- General Practice Dentistry
- Kyle, TX
National Provider Identifier
1285746495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 16587
- Practice address
- 120 Pintail St
Kyle, TX 78640-8894 - Phone
- (512) 268-4110
- NPI assigned
- Sep 1, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 16587 | TX | Primary |
Addresses
Primary practice location
120 Pintail St
Kyle, TX 78640-8894
Mailing address
120 Pintail St
Kyle, TX 78640-8894
Phone (512) 268-4110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16587 | Other | TX | DENTIST |
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 |
|---|---|---|---|
| 16587 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285746495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 PINTAIL ST",
"city": "KYLE",
"state": "TX",
"postal_code": "786408894",
"telephone_number": "512-268-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 PINTAIL ST",
"city": "KYLE",
"state": "TX",
"postal_code": "786408894",
"telephone_number": "512-268-4110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELTON",
"first_name": "ROBERTA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "16587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTIST",
"identifier": "16587",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kyle, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.