DR. NICHOLAS RYAN MELLUM DMD NPI 1053454173

NPI Information

DR. Nicholas Ryan Mellum, DMD is a general practice dentist in Portland, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Nicholas Ryan Mellum, DMD NPI is 1053454173. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8910 N KELLOGG ST
PORTLAND, OR
ZIP 97203-002
Phone: (503) 286-4492

The NPI 1053454173 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 5/10/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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