Individual provider Active NPI

Christine Marie Melito, D.M.D.

  • Endodontics
  • Malden, MA
National Provider Identifier
1407946718
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
21142 Issued in MA
Practice address
10 Holden St
Malden, MA 02148-5238
Phone
(781) 321-6006
NPI assigned
Oct 15, 2006
Last updated
Nov 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 21142 MA Primary

Addresses

Primary practice location

10 Holden St
Malden, MA 02148-5238

Mailing address

10 Holden St
Malden, MA 02148-5238
Phone (781) 321-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150521001861 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305166984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21142MAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1407946718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HOLDEN ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485238",
            "telephone_number": "781-321-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HOLDEN ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485238",
            "telephone_number": "781-321-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELITO",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "21142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

Verify at the official NPI Registry.