Individual provider Active NPI

Melinda A Garcia, DDS

  • Dentist
  • Leawood, KS
National Provider Identifier
1972601714
Registry record updated Sep 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
KS60390 Issued in KS
Practice address
7930 Lee Blvd
Leawood, KS 66206-1215
Phone
(913) 383-5373
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X KS60390 KS Primary

Addresses

Primary practice location

7930 Lee Blvd
Leawood, KS 66206-1215

Mailing address

7427 Village Dr
Prairie Village, KS 66208-2862
Phone (913) 787-1163

Other names 1

  • Dr. Melinda A Peterson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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

Enrollment IDStateProvider typePAC IDDetails
I20150908000464 KS Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476865346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KS60390KSMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1972601714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7427 VILLAGE DR",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662082862",
            "telephone_number": "913-787-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7930 LEE BLVD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662061215",
            "telephone_number": "913-383-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MELINDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "KS60390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "PETERSON",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.