Melissa S Amundson DDS PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MELISSA S AMUNDSON DDS PA

Doing business as

Perry Family Dental and Implants

Practice address

1204 N Center St
Perry, FL 32347-2038

Phone

(850) 584-4613

NPI assigned

May 11, 2021

Last updated

May 11, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

MELISSA S AMUNDSON DDS PAAs reported in NPPES

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

Authorized official

Name

Melissa Amundson, DDSNPI 1689823619

Title

Owner/Surgeon

Phone

(850) 584-4613

Specialties & licenses 4

Addresses

Other names 1

• Perry Family Dental and Implants Doing business as

Part of

Melissa S Amundson DDS PA

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa Sioux Amundson, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Tallahassee, FL
  • NPI 1689823619

  Oral and Maxillofacial Surgery

  NPD Authorized official
• Joesph Warren Fuller III, D.D.S.

  • General Practice Dentistry
  • Perry, FL
  • NPI 1548344757
  NPD (past)

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620691200000",
    "number": "1326622887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 PLANTATION RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034208",
            "telephone_number": "847-721-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N CENTER ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472038",
            "telephone_number": "850-584-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA S AMUNDSON DDS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MELISSA S AMUNDSON DDS PA",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A",
        "authorized_official_last_name": "AMUNDSON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "OWNER/SURGEON",
        "authorized_official_telephone_number": "850-584-4613",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Perry Family Dental and Implants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Wambolt McCormick, FNP-C
• Stephanie N McCranie
• Genevieve Blanchard McGowan, C.R.N.A.
• Keandra Monique McNeal, APRN
• Alissa S McQuiston, RN
• Jordon Paige Metcalf
• Ashlyn Mills, PTA
• Evalena Kaye Mock, LMT
• Ghulam Mohammed, MD
• Morgan Family Dentistry PLLC

• Dentist in Perry, FL
• Providers in Perry, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.