Provider Demographics
NPI:1467652446
Name:NIX, MELISSA SEIBOLD (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SEIBOLD
Last Name:NIX
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MONTGOMERY HWY
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1804
Mailing Address - Country:US
Mailing Address - Phone:205-871-2592
Mailing Address - Fax:205-871-2506
Practice Address - Street 1:300 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1804
Practice Address - Country:US
Practice Address - Phone:205-871-2592
Practice Address - Fax:205-871-2506
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL55461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice