Melissa Kay Colasurdo, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D10105 Issued in OR

Practice address

10535 NE Glisan St
Portland, OR 97220-4077

Phone

(503) 444-8181

NPI assigned

Aug 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1922417989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 SW DONNER WAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972391540",
            "telephone_number": "503-385-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-444-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLASURDO",
        "first_name": "MELISSA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nalini Anne Colaco, M.D., PH.D.
• Amy Rose Colagiovanni Morrison
• Christopher Colasurdo, DO, MPH
• John Gabriel Colasurdo, DMD
• Marco Colasurdo
• Vincent Colasurdo, D.M.D.
• Colasurdodmd LLC
• Estefania Colazo
• Isabella Raven Colbert
• Jewell Colbert

• 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 Aug 4, 2014; 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.