Melisa Susanto, DDS
NPI 1396044517 · Pediatric Dentistry · Puyallup, WA
Enrolled with Medicare as Order and Referring Only - Dentist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Melisa Susanto, DDS is a Pediatric Dentistry provider in Puyallup, WA (NPI 1396044517).
Provider details
- NPI number
- 1396044517
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- License
- 2901020349 (MI)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 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
Mailing address
Registry dates
- Enumerated
- 2011-03-28
- Last updated
- 2014-07-28
Frequently asked questions
- What is Melisa Susanto's NPI number?
- Melisa Susanto's National Provider Identifier (NPI) is 1396044517, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Melisa Susanto's specialty?
- Melisa Susanto is listed in the NPPES registry with a primary specialty of Pediatric Dentistry (Dental Providers).
- Where is Melisa Susanto located?
- Melisa Susanto's practice location on file with NPPES is 16810 Meridian E, Puyallup, WA 98375-9604.
- What is Melisa Susanto's phone number?
- The practice phone number listed in the NPPES registry for Melisa Susanto is (626) 241-2669.
- Does Melisa Susanto accept Medicare?
- Melisa Susanto is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Melisa Susanto's NPI active?
- Yes — Melisa Susanto's NPI (1396044517) is active in the NPPES registry as of the last update on 2014-07-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.