Organization Active NPI

Ernest S. Melanson, DDS,Ms,PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Worcester, MA
National Provider Identifier
1972656734
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10787 Issued in MA
Legal business name
ERNEST S. MELANSON, DDS,MS,PC
Practice address
10 Winthrop St
Worcester, MA 01604-4435
Phone
(508) 755-2207
Fax
(508) 755-2275
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ernest S. Melanson, DDS, MS
Title
President
Phone
(508) 755-2207

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 10787 MA Primary

Addresses

Primary practice location

10 Winthrop St
Worcester, MA 01604-4435

Mailing address

10 Winthrop St
Worcester, MA 01604-4435
Phone (508) 755-2207

Other identifiers 3

IdentifierTypeStateIssuer
9733043MedicaidMA
V04647OtherMABLUE CROSS BLUE SHIELD
0210161MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972656734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WINTHROP ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044435",
            "telephone_number": "508-755-2207",
            "fax_number": "508-755-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WINTHROP ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044435",
            "telephone_number": "508-755-2207",
            "fax_number": "508-755-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST S. MELANSON, DDS,MS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELANSON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-755-2207",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "10787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9733043",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "V04647",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0210161",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.