Individual provider Active NPI

Jose R. Mellado, D.M.D.

  • Endodontics
  • Coral Gables, FL
National Provider Identifier
1801941398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN0014764 Issued in FL
Practice address
299 Alhambra Cir Ste 202
Coral Gables, FL 33134-5116
Phone
(305) 441-0302
Fax
(305) 441-0177
NPI assigned
Jan 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN0014764 FL Primary

Addresses

Primary practice location

299 Alhambra Cir Ste 202
Coral Gables, FL 33134-5116

Mailing address

299 Alhambra Cir Ste 202
Coral Gables, FL 33134-5116
Phone (305) 441-0302

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

LicenseStateTypeSpecialty
DN0014764FLMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801941398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 ALHAMBRA CIR STE 202",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345116",
            "telephone_number": "305-441-0302",
            "fax_number": "305-441-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 ALHAMBRA CIR STE 202",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345116",
            "telephone_number": "305-441-0302",
            "fax_number": "305-441-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLADO",
        "first_name": "JOSE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN0014764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

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.

Verify at the official NPI Registry.