Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Nathaniel Simon Mellul, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043006554

Dr. Nathaniel Simon Mellul, DMD is a Student in an Organized Health Care Education/Training Program in Phoenix, Arizona. Practices as a sole proprietor. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

420 W Watkins St
Phoenix, AZ 85003-2830
Phone: (602) 261-6842
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1043006554
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedApril 19, 2025
Last updated in NPPESMay 6, 2025
Certification dateMay 6, 2025

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