MELISA SUSANTO (DDS) – Pediatric Dentistry, NPI 1396044517

Pediatric Dentistry

MELISA SUSANTO (DDS) is a healthcare provider. based in Puyallup, Washington. specializing in Pediatric Dentistry. They hold the professional credentials DDS. They hold a License No. 2901020349 (MI). The NPI Number for MELISA SUSANTO (DDS) is 1396044517

Main info

Female

Name

MELISA SUSANTO (DDS)

NPI

1396044517

Phone

(626) 241-2669

Address

16810 MERIDIAN E

Enumeration Date

28 March 2011

Last Update Date

28 July 2014

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience58

Completeness75

Years active:15State licenses:2Digital endpointsOther names

Provider Addresses for MELISA SUSANTO (DDS)

16810 MERIDIAN E
SUITE J104
PUYALLUP, WA 983759604
Phone: (626) 241-2669
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2023-10-05 • Largest payer in this snapshot: VOCO America Inc. ($14).

Total Amount

$27

General + Research + Ownership

Payments

Total payment records

General Amount

$27

General payments

Research Amount

Research funding

Ownership Amount

Ownership interests

Ownership Count

Ownership records

Last Payment Date

2023-10-05

Latest reported date

Top Companies

Largest payers in this snapshot

Company	Amount
VOCO America Inc.	$14
Elevate Oral Care	$13

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-09-22

PECOS data refreshed: 2026-05-27

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98375)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I use this page to confirm MELISA SUSANTO (DDS)'s NPI?

Yes. MELISA SUSANTO (DDS) is listed with NPI 1396044517 in the public NPI dataset.

Does CMS list MELISA SUSANTO (DDS) as active?

Yes — MELISA SUSANTO (DDS) is active in the NPI listing used on this page.

What taxonomy line describes MELISA SUSANTO (DDS)?

For research purposes, treat MELISA SUSANTO (DDS) as Pediatric Dentistry in this dataset. Clinical services aligned with this taxonomy classification.

Where is MELISA SUSANTO (DDS) based?

MELISA SUSANTO (DDS) is tied to Puyallup, Washington in the data we show; additional addresses may exist on the full record.

Why does MELISA SUSANTO (DDS) have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.