Jonathan Melberg

Primary specialty

DentistTaxonomy code 122300000X

License

12012430A Issued in IN

Practice address

11065 Pacific Crest PL NW Ste B105
Silverdale, WA 98383-6607

Phone

(360) 261-6154

NPI assigned

Nov 13, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Washington Dental Corporation

  • General Practice Dentistry
  • Silverdale, WA
  • NPI 1295108694
  NPD (past)

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1447624473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD",
            "address_2": "COMMANDING OFFICER",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "telephone_number": "910-451-2208",
            "fax_number": "910-451-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11065 PACIFIC CREST PL NW STE B105",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983836607",
            "telephone_number": "360-261-6154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2D DENBN/NDC, PSC 20130 315 MCHUGH BLVD",
            "address_2": "COMMANDING OFFICER",
            "address_purpose": "LOCATION",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420130",
            "country_code": "US",
            "telephone_number": "910-451-2208 x203",
            "fax_number": "910-451-8036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELBERG",
        "first_name": "JONATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-13",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012430A",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60813142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April M McNeill, LMP
• Victoria Suzanne McRae, DDS
• MCS Counseling Group LLC
• Medical Consulting Associates, PLLC
• Thomas Jan Meeks, D.O.
• Julie E. Memke, PHARM.D.
• Bobbi Menger, LMP
• Greg W Mennie, PA-C
• Bianca Trinidad Mercado, PA-C
• Robert Joseph Meszko, RN, SRNA

• Dentist in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.