Provider Demographics
NPI:1356448286
Name:MINER, MELINDA KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:KAY
Last Name:MINER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DOWNING AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2461
Mailing Address - Country:US
Mailing Address - Phone:785-625-2200
Mailing Address - Fax:785-625-0079
Practice Address - Street 1:1010 DOWNING AVE STE 10
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2461
Practice Address - Country:US
Practice Address - Phone:785-625-2200
Practice Address - Fax:785-625-0079
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100367900-BMedicaid
KS0722246OtherTRICARE TDP
KS920275OtherUNITED CONCORDIA
KS116706OtherBLUE CROSS BLUE SHIELD