Active NPI
Amy Lynn Melok
- General Practice Dentistry
- Nutley, NJ
National Provider Identifier
1386284263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22D10282200
- Practice address
- 242 Washington Ave Unit D
Nutley, NJ 07110 - Phone
- (973) 667-1567
- NPI assigned
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 22D10282200 | NJ | Primary |
Addresses
Primary practice location
242 Washington Ave Unit D
Nutley, NJ 07110
Mailing address
11 Maple Ave
Haskell, NJ 07420
Phone (201) 889-1432
Other practice location 1
701 Frank E Rodgers Blvd N
Harrison, NJ 07029-2627
Phone (973) 483-5902
Other practice location 2
40 9th St
North Arlington, NJ 07031-4763
Phone (201) 889-1432
Other practice location 3
1 Bay Ave
Montclair, NJ 07042-4837
Phone (973) 429-6037
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 |
|---|---|---|---|
| 22D10282200 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629676800000",
"number": "1386284263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 MAPLE AVE",
"city": "HASKELL",
"state": "NJ",
"postal_code": "07420",
"telephone_number": "201-889-1432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 WASHINGTON AVE UNIT D",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "07110",
"telephone_number": "973-667-1567"
}
],
"practiceLocations": [
{
"address_1": "701 Frank E Rodgers Blvd N",
"address_purpose": "LOCATION",
"city": "Harrison",
"state": "NJ",
"postal_code": "070292627",
"country_code": "US",
"telephone_number": "973-483-5902",
"fax_number": "973-483-0123",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 9th St",
"address_purpose": "LOCATION",
"city": "North Arlington",
"state": "NJ",
"postal_code": "070314763",
"country_code": "US",
"telephone_number": "201-889-1432",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Bay Ave",
"address_purpose": "LOCATION",
"city": "Montclair",
"state": "NJ",
"postal_code": "070424837",
"country_code": "US",
"telephone_number": "973-429-6037",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MELOK",
"first_name": "AMY LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2021-08-23",
"certification_date": "2021-08-05",
"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": "NJ",
"license": "22D10282200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.