Tim A Melancon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5046 Issued in LA

Practice address

3414 Hessmer Ave
Ste 201
Metairie, LA 70002-4759

Phone

(504) 889-1165

Fax

(504) 889-1177

NPI assigned

Mar 1, 2007

Sex

Male

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 LA

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

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679601959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 HESSMER AVE",
            "address_2": "STE 201",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024759",
            "telephone_number": "504-889-1165",
            "fax_number": "504-889-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 HESSMER AVE",
            "address_2": "STE 201",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024759",
            "telephone_number": "504-889-1165",
            "fax_number": "504-889-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELANCON",
        "first_name": "TIM",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassidy Ann Melancon
• Dean Jeffrey Melancon Jr., CRNA
• Hylie Daun Melancon
• Olivia Paige Melancon, MA, CCC-SLP
• Sydney Smith Melancon, MD
• Andrew Thomas Melcher, MD
• Archie Melcher, MD
• Brenda Jean Melder
• Gina Marie Genovese Melerine
• Anthony Melito, LPC

• General Practice Dentistry in Metairie, LA
• Providers in Metairie, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.