Melissa Maria Medina Matos, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3294 Issued in PR

Practice address

Carr. 628 KM 3.9
Bo. Manantiales, Sector Jobales
Arecibo, PR 00612

Phone

(787) 881-1350

NPI assigned

Apr 25, 2018

Last updated

Jun 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Melissa Medina Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1417445420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY GARDENS AUSUBO ST. J-23",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-233-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 628 KM 3.9",
            "address_2": "BO. MANANTIALES, SECTOR JOBALES",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-881-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA MATOS",
        "first_name": "MELISSA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-25",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PR",
            "license": "3294",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "MEDINA",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Medicina Integral 2010
• Luis Alberto Medina Aviles, MD
• Lekeshia Kristina Medina Cortez
• Saturnino Medina Feliciano
• Francisco Medina Martinez
• Maribel Medina Teron
• Carlos Ruben Medina-Mejias, DC
• Juan Medina-Ramos, RN
• Alejandro Medina, PHARMD
• Diantte Joan Medina

• General Practice Dentistry in Arecibo, PR
• Providers in Arecibo, PR by specialty
• General Practice Dentistry in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.