Active NPI
Steven Joseph Melonakos, D.D.S.
- Dentist
- Mooresville, NC
National Provider Identifier
1306167333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8966
- Practice address
- 130 Plantation Ridge Dr
Suite 201
Mooresville, NC 28117-9238 - Phone
- (704) 660-5800
- Fax
- (704) 660-5801
- NPI assigned
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 8966 | NC | Primary |
Addresses
Primary practice location
130 Plantation Ridge Dr
Suite 201
Mooresville, NC 28117-9238
Mailing address
130 Plantation Ridge Dr
Suite 201
Mooresville, NC 28117-9238
Phone (704) 660-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5915795 | Medicaid | NC |
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 |
|---|---|---|---|
| 8966 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1306167333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 PLANTATION RIDGE DR",
"address_2": "SUITE 201",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281179238",
"telephone_number": "704-660-5800",
"fax_number": "704-660-5801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 PLANTATION RIDGE DR",
"address_2": "SUITE 201",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281179238",
"telephone_number": "704-660-5800",
"fax_number": "704-660-5801"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELONAKOS",
"first_name": "STEVEN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-14",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "8966",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5915795",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.