Individual provider Active NPI

Melissa Santos Perez, DMD

  • General Practice Dentistry
  • Birmingham, AL
National Provider Identifier
1306291711
Registry record updated Jun 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6369 Issued in AL
Practice address
1820 Gadsden Hwy Ste 112
Birmingham, AL 35235
Phone
(205) 490-8515
NPI assigned
May 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 6369 AL Primary

Addresses

Primary practice location

1820 Gadsden Hwy Ste 112
Birmingham, AL 35235

Mailing address

1801 Winnsboro Rd
Birmingham, AL 35213-1742

Other practice location 1

39 Calle Reina Cristina
Guaynabo, PR 00969-3271
Phone (718) 920-4321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170927003097 AL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7214201326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6369ALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Health Group Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530316800000",
    "number": "1306291711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 WINNSBORO RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352131742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 GADSDEN HWY STE 112",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35235",
            "telephone_number": "205-490-8515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 Calle Reina Cristina",
            "address_purpose": "LOCATION",
            "city": "Guaynabo",
            "state": "PR",
            "postal_code": "009693271",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTOS PEREZ",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2018-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.