Individual provider Active NPI

Melzar Thayer Richards, DDS

  • Dentist
  • Ithaca, NY
National Provider Identifier
1316043995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0312601 Issued in NY
Practice address
22 Arrowwood Dr
Ste C
Ithaca, NY 14850
Phone
(607) 257-1010
Fax
(607) 257-1982
NPI assigned
Sep 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0312601 NY Primary

Addresses

Primary practice location

22 Arrowwood Dr
Ste C
Ithaca, NY 14850

Mailing address

22 Arrowwood Dr
Ste C
Ithaca, NY 14850-1857
Phone (607) 257-1010

Other identifiers 1

IdentifierTypeStateIssuer
00420902MedicaidNY

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

LicenseStateTypeSpecialty
0312601NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316043995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ARROWWOOD DR",
            "address_2": "STE C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148501857",
            "telephone_number": "607-257-1010",
            "fax_number": "607-257-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ARROWWOOD DR",
            "address_2": "STE C",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "14850",
            "telephone_number": "607-257-1010",
            "fax_number": "607-257-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDS",
        "first_name": "MELZAR",
        "middle_name": "THAYER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0312601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00420902",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

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.

Verify at the official NPI Registry.