Melrose Square Dental Office

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60377 Issued in CA

Legal business name

MELROSE SQUARE DENTAL OFFICE

Practice address

1680 S Melrose Dr Ste 108
Vista, CA 92081-5472

Phone

(760) 727-6800

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Mojdeh Tajbakhsh

Title

Dentist

Phone

(760) 727-6800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1700169323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1477 SAN PABLO DR",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 S MELROSE DR STE 108",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920815472",
            "telephone_number": "760-727-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSE SQUARE DENTAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "TAJBAKHSH",
        "authorized_official_first_name": "MOJDEH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "760-727-6800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Billy Mejia
• Catherine Melendez
• Melissa Hurd Medical Corporation
• Rebecca Mellman, PT
• Julia Lynn Mellusi, LCSW
• Memory Lane LLC
• Memory Lane LLC
• Cynthia Mendez Sanchez
• Christopher Raul Mendez
• Hailey Ashley Mendez

• General Practice Dentistry in Vista, CA
• Providers in Vista, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.