Melissa Marie Pysnak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5061 Issued in ID

Practice address

8850 W Emerald St Ste 150
Boise, ID 83704-4809

Phone

(208) 323-2294

NPI assigned

Jul 11, 2019

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MP Family Dental PLLC

  dba Pearl Dentistry

  • Dentist
  • Caldwell, ID
  • NPI 1396656427
  Authorized official Same address or phone
• Emerald West Family Dentistry

  • Dentist
  • Boise, ID
  • NPI 1639238124
  NPD (past)
• Jason Champagne Idaho 1, PLLC

  dba Emerald West Family Dentistry

  • General Practice Dentistry
  • Boise, ID
  • NPI 1558119073
  NPD (past)

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1528610359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 ORCHARD PINES LOOP",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840105673",
            "telephone_number": "801-309-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8850 W EMERALD ST STE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044809",
            "telephone_number": "208-323-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYSNAK",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D5061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pure Vita Co.
• Mackenzie Purnell, MS, LPC, NCC
• Marybeth Puzio, CRNA
• Nicole F Pyle, PA-C
• Stephen Pyper
• Q17 Health Partners LLC
• Huiling Qi, M.D.
• Quality Care Counseling Center Inc.
• Quality Family Dentistry
• Qualls Footnotes Counseling, LLC

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.