Active NPI
Robert Mellor, DDS
- Dentist
- Farmington Hills, MI
National Provider Identifier
1467625087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12010522A
- Practice address
- 33533 W 12 Mile Rd
Suite 150
Farmington Hills, MI 48331-3354 - Phone
- (248) 442-6600
- NPI assigned
- Apr 3, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12010522A | IN | Primary |
Addresses
Primary practice location
33533 W 12 Mile Rd
Suite 150
Farmington Hills, MI 48331-3354
Mailing address
6618 Southern Ridge Dr
Indianapolis, IN 46237-2978
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12010522A | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1467625087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6618 SOUTHERN RIDGE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462372978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33533 W 12 MILE RD",
"address_2": "SUITE 150",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483313354",
"telephone_number": "248-442-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLOR",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-03",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12010522A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.