Joe Medellin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

56535 Issued in CA

Practice address

8949 Reseda Blvd Ste 116
Northridge, CA 91324

Phone

(818) 280-5596

Fax

(818) 975-5596

NPI assigned

Jan 31, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Joe Medellin DDS, Inc.

  • Dentist
  • Northridge, CA
  • NPI 1245708866
  NPD (past) Authorized official
• Rubix Dental Group Inc

  • General Practice Dentistry
  • Northridge, CA
  • NPI 1497130249
  NPD (past)

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1326226440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8949 RESEDA BLVD STE 116",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243995",
            "telephone_number": "818-280-5596",
            "fax_number": "818-975-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8949 RESEDA BLVD STE 116",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "91324",
            "telephone_number": "818-280-5596",
            "fax_number": "818-975-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15537 Dalwood Ave",
            "address_purpose": "LOCATION",
            "city": "Norwalk",
            "state": "CA",
            "postal_code": "906506238",
            "country_code": "US",
            "telephone_number": "714-362-4366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDELLIN",
        "first_name": "JOE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-31",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56535",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MD Breath Testing Laboratory
• MD Hospice Group
• Mde & Kae Holding LLC.
• Marisa Mead, LCSW
• Med-Century Pharmacy Inc
• Medical Specialty Pharmacy
• Medicus Home Health Care Inc
• Elizabeth Medina
• Jessica Medina
• Joyce L. Medley

• General Practice Dentistry in Northridge, CA
• Providers in Northridge, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.