Active NPI
Melanie Merriam, RDH
- Dental Hygienist
- Syracuse, NY
National Provider Identifier
1689700312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 016947-1
- Practice address
- 100 Intrepid LN
Syracuse, NY 13205-2546 - Phone
- (315) 492-8138
- Fax
- (315) 492-6169
- NPI assigned
- Feb 26, 2007
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 016947-1 | NY | Primary |
Addresses
Primary practice location
100 Intrepid LN
Syracuse, NY 13205-2546
Mailing address
4152 Gates Rd
Jamesville, NY 13078-9624
Phone (315) 682-7881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016947-1 | Other | NY | RDH LICENSE # |
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 |
|---|---|---|---|
| 016947-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689700312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4152 GATES RD",
"city": "JAMESVILLE",
"state": "NY",
"postal_code": "130789624",
"telephone_number": "315-682-7881",
"fax_number": "315-492-6169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 INTREPID LN",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052546",
"telephone_number": "315-492-8138",
"fax_number": "315-492-6169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRIAM",
"first_name": "MELANIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NY",
"license": "016947-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RDH LICENSE #",
"identifier": "016947-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.