Michael Eugene Melland, RN BSN DDS
Individual provider Active NPI Dentist · Box Elder, MT
NPI 1467588988 · NPPES record last updated Sep 12, 2023
Key facts
- NPI
- 1467588988
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- DEN-DEN-LIC-25965 (MT)
- Practice address
- 6850 Upper Box Elder Rd
Box Elder, MT 59521-9073 - Phone
- (406) 395-4486
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220125002836 | MT | Practitioner - Dentist | 8527237510 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN-DEN-LIC-25965 | MT | MD | Dentist |
| 7197 | KS | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rocky Boy Health Center | Current |
Accepting new patients |
Locations
6850 Upper Box Elder Rd
Box Elder, MT 59521
Phone (406) 395-4374
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7197 | KS | |
| Dentist | 122300000X | DEN-DEN-LIC-25965 | MT | Yes |
Addresses
Primary practice location
6850 Upper Box Elder Rd
Box Elder, MT 59521-9073
Mailing address
717 3Rd St
Havre, MT 59501-3721
Phone (701) 421-1463
Other practice location 1
1058 College Dr
New Town, ND 58763-9112
Phone (701) 627-7927
Other providers in Box Elder, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.