Individual provider Active NPI

Melissa L Pecoraro, DMD

  • Periodontics
  • Clark, NJ
National Provider Identifier
1457329328
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI02152901 Issued in NJ
Practice address
1119 Raritan Rd
Suite 1
Clark, NJ 07066-1315
Phone
(732) 382-9090
Fax
(732) 396-1527
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 22DI02152901 NJ Primary

Addresses

Primary practice location

1119 Raritan Rd
Suite 1
Clark, NJ 07066-1315

Mailing address

1119 Raritan Rd
Suite 1
Clark, NJ 07066-1315
Phone (732) 382-9090

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

LicenseStateTypeSpecialty
22DI02152901NJMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank J Pecoraro DDS PA Richard M Kelner DMD PA Periodontics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1457329328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 RARITAN RD",
            "address_2": "SUITE 1",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661315",
            "telephone_number": "732-382-9090",
            "fax_number": "732-396-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 RARITAN RD",
            "address_2": "SUITE 1",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661315",
            "telephone_number": "732-382-9090",
            "fax_number": "732-396-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORARO",
        "first_name": "MELISSA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02152901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.