Melissa Aylworth, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901019846 Issued in MI

Practice address

3258 Bowers Harbor Rd
Traverse City, MI 49686-9737

Phone

(231) 223-4232

Fax

(231) 223-9205

NPI assigned

Jun 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

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.

• Old Mission Peninsula Dentistry RC

  dba Old Mission Dentistry

  • Dentist
  • Traverse City, MI
  • NPI 1497117923
  NPD (past) Authorized official

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1467614115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3258 BOWERS HARBOR RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869737",
            "telephone_number": "231-223-4232",
            "fax_number": "231-223-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3258 BOWERS HARBOR RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869737",
            "telephone_number": "231-223-4232",
            "fax_number": "231-223-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYLWORTH",
        "first_name": "MELISSA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance Averill, PH.D, LMSW, ACSW
• Ann M Avery, NURSE PRACTITIONER
• Ashley Avery
• Bianca Avolio
• Joel Thomas Ayala, OTR
• B. Jeffrey Pulk, P.C. (Old Town Optical)
• Baas Optometry PC (Old Town Optical)
• Nathan G Baas, O.D.
• Anne M Baase, LPC, MSW
• Back on Track Chiropractic P C

• Dentist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.