Melanie Janelle Grant, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D9316 Issued in OR

Practice address

17130 SW Upper Boones Ferry Rd
Portland, OR 97224-7004

Phone

(503) 952-2100

Fax

(503) 624-8732

NPI assigned

Mar 19, 2009

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

• Ms. Melanie Janelle Haynes Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1821239872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2164",
            "fax_number": "503-526-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17130 SW UPPER BOONES FERRY RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972247004",
            "telephone_number": "503-952-2100",
            "fax_number": "503-624-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MELANIE",
        "middle_name": "JANELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "HAYNES",
            "middle_name": "JANELLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kylie Morgan Grant
• Lora Grant
• Lyntressa Danielle Grant, PMHNP-BC
• Madeleine Suzanne Bullick Grant, PHARMD
• Mary E Grant, ANP
• Michael Grant
• Nancy Grant, M.D.
• Rowan M Grant
• Stephen Thomas Grant, LCSW
• Vanessa Joan Grant

• Dentist in Portland, OR
• Providers in Portland, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.