Melissa Madison, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14587 Issued in MN

Practice address

4325 Grand Ave
Duluth, MN 55807-2730

Phone

(218) 628-7035

Fax

(218) 624-6594

NPI assigned

Jul 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1750952792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803709",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072730",
            "telephone_number": "218-628-7035",
            "fax_number": "218-624-6594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548803709",
            "country_code": "US",
            "telephone_number": "715-394-5411",
            "fax_number": "715-392-5086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 W Superior St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558021722",
            "country_code": "US",
            "telephone_number": "218-722-7831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADISON",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002683-15",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Merle Maddy
• Jacob Maderich, PHARM D
• Madison-Nelson Family Dentistry
• Gary John Madison, D.D.S.
• Joan Elizabeth Madison
• Emily Kate Madole, PHARM.D.
• Alexandra Madsen, PHARM.D.
• Cassie Madsen, RD
• Jerry Lynn Madsen, RN, FNP-BC
• Gretchen Lynn Madson

• General Practice Dentistry in Duluth, MN
• Providers in Duluth, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.