OrganizationActive
Melissa Marks Gustafson, DDS, PA
NPI 1962936104 · Dental Clinic/Center · Charlotte, NC
Melissa Marks Gustafson, DDS, PA is a Dental Clinic/Center organization in Charlotte, NC (NPI 1962936104).
Provider details
- NPI number
- 1962936104
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Melissa Gustafson, Practice Owner(704) 596-0021
- License
- 7153 (NC)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
3010 Baucom Rd Ste 200
Charlotte, NC 28269-6765
Phone: (704) 596-0021
Fax: (704) 599-1155
Street-level locationGet directions
Mailing address
3010 Baucom Rd Ste 200
Charlotte, NC 28269-6765
Other names (DBA / former)
- Doing business as
- Mallard Creek Family Dentistry
Registry dates
- Enumerated
- 2017-04-14
- Last updated
- 2017-04-14
Frequently asked questions
- What is Melissa Marks Gustafson, DDS, PA's NPI number?
- Melissa Marks Gustafson, DDS, PA's National Provider Identifier (NPI) is 1962936104, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Melissa Marks Gustafson, DDS, PA?
- Melissa Marks Gustafson, DDS, PA is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Melissa Marks Gustafson, DDS, PA located?
- Melissa Marks Gustafson, DDS, PA's practice location on file with NPPES is 3010 Baucom Rd Ste 200, Charlotte, NC 28269-6765.
- What is Melissa Marks Gustafson, DDS, PA's phone number?
- The practice phone number listed in the NPPES registry for Melissa Marks Gustafson, DDS, PA is (704) 596-0021.
- Who is the authorized official for Melissa Marks Gustafson, DDS, PA?
- The authorized official listed on Melissa Marks Gustafson, DDS, PA's NPPES record is Melissa Gustafson, Practice Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Melissa Marks Gustafson, DDS, PA's NPI active?
- Yes — Melissa Marks Gustafson, DDS, PA's NPI (1962936104) is active in the NPPES registry as of the last update on 2017-04-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.