Active NPI
Melanie Marshall
- General Practice Dentistry
- Burleson, TX
National Provider Identifier
1598824575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22724
- Practice address
- 140 NW John Jones Dr
Suite 120
Burleson, TX 76028-8157 - Phone
- (817) 426-3355
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22724 | TX | Primary |
Addresses
Primary practice location
140 NW John Jones Dr
Suite 120
Burleson, TX 76028-8157
Mailing address
650 International Pkwy
Suite 100
Richardson, TX 75081-6612
Phone (817) 426-3355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160428000296 | TX | Order and Referring Only - Dentist | 0345554879 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22724 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1598824575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 INTERNATIONAL PKWY",
"address_2": "SUITE 100",
"city": "RICHARDSON",
"state": "TX",
"postal_code": "750816612",
"telephone_number": "817-426-3355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 NW JOHN JONES DR",
"address_2": "SUITE 120",
"city": "BURLESON",
"state": "TX",
"postal_code": "760288157",
"telephone_number": "817-426-3355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "MELANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "22724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.