OrganizationActive
Mellon Dental Management, PLLC
NPI 1336852144 · General Practice Dentistry · Bandera, TX
Provider details
- NPI number
- 1336852144
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Randi Mellon, Dentist(830) 796-3548
Specialties & taxonomies
Dental Providers
- Dental Clinic/Center261QD0000X
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
584 State Highway 16 S
Bandera, TX 78003-3808
Phone: (830) 796-3548
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3612
Bandera, TX 78003-6611
Other names (DBA / former)
- Doing business as
- Tooth Scootin' Boogie
- Doing business as
- Tooth Scootin' Boogie
Registry dates
- Enumerated
- 2022-12-27
- Last updated
- 2023-02-07
- Certified
- 2023-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.