Active NPI
Mel Collazo, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Little Rock, AR
National Provider Identifier
1861552937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2749
- Practice address
- 11811 Hinson Rd Ste 100
Little Rock, AR 72212-3472 - Phone
- (501) 221-0004
- Fax
- (501) 219-0300
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2749 | AR | Primary |
Addresses
Primary practice location
11811 Hinson Rd Ste 100
Little Rock, AR 72212-3472
Mailing address
11811 Hinson Rd Ste 100
Little Rock, AR 72212-3472
Phone (501) 221-0004
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2749 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861552937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11811 HINSON RD STE 100",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722123472",
"telephone_number": "501-221-0004",
"fax_number": "501-219-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11811 HINSON RD STE 100",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722123472",
"telephone_number": "501-221-0004",
"fax_number": "501-219-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO",
"first_name": "MEL",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "AR",
"license": "2749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
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.