Melissa K Zyk, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE016062 Issued in MO

Practice address

560 E 14TH St
Washington, MO 63090-4535

Phone

(636) 390-9991

Fax

(636) 390-9985

NPI assigned

Nov 7, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Melissa K Boren Former name

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lighthouse Dental 63090

  • General Practice Dentistry
  • Washington, MO
  • NPI 1801523592
  NPD Authorized official
• MZ TMD and ZZZ LLC

  • General Practice Dentistry
  • Washington, MO
  • NPI 1376291138
  NPD Authorized official

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1770564858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 E 14TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904535",
            "telephone_number": "636-390-9991",
            "fax_number": "636-390-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 E 14TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904535",
            "telephone_number": "636-390-9991",
            "fax_number": "636-390-9985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZYK",
        "first_name": "MELISSA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "DE016062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "BOREN",
            "middle_name": "K",
            "prefix": "MRS.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria L Yenzer, NP
• Meriel Yingling
• Tanner Cole Young, FNP
• Vernon Leroy Young, M.D.
• Changqing Zhao, M.D.

• General Practice Dentistry in Washington, MO
• Providers in Washington, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.