Individual provider Active NPI

Melissa Joan Wendling, DMD

  • Dentist
  • Marietta, GA
National Provider Identifier
1538804265
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN122986 Issued in GA
Practice address
2551 Roswell Rd Ste 100
Marietta, GA 30062-4761
Phone
(770) 514-5055
NPI assigned
Apr 27, 2022
Last updated
Mar 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12782256-9923 UT
Dentist 122300000X DN122986 GA Primary

Addresses

Primary practice location

2551 Roswell Rd Ste 100
Marietta, GA 30062-4761

Mailing address

2551 Roswell Rd Ste 100
Marietta, GA 30062-4761
Phone (770) 514-5055

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
DN122986GAMDDentist
12782256-9923UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Centerville Dental Group, LLP PastSince May 1, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1538804265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 ROSWELL RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624761",
            "telephone_number": "770-514-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 ROSWELL RD STE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624761",
            "telephone_number": "770-514-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDLING",
        "first_name": "MELISSA",
        "middle_name": "JOAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "12782256-9923",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN122986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.