Active NPI
Jason Mark Melde, DMD
- Endodontics
- Show Low, AZ
National Provider Identifier
1720032220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 5503
- Practice address
- 51 S White Mountain Rd
Show Low, AZ 85901-6105 - Phone
- (928) 537-2525
- Fax
- (928) 537-0025
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 5503 | AZ | Primary |
Addresses
Primary practice location
51 S White Mountain Rd
Show Low, AZ 85901-6105
Mailing address
6223 E Berneil LN
Paradise Valley, AZ 85253-1848
Phone (602) 315-2242
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170111000233 | AZ | Order and Referring Only - Other (Non-Physician) | 1951682657 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5503 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246838400000",
"number": "1720032220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6223 E BERNEIL LN",
"city": "PARADISE VALLEY",
"state": "AZ",
"postal_code": "852531848",
"telephone_number": "602-315-2242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 S WHITE MOUNTAIN RD",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859016105",
"telephone_number": "928-537-2525",
"fax_number": "928-537-0025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELDE",
"first_name": "JASON",
"middle_name": "MARK",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2009-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "AZ",
"license": "5503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.