Provider Demographics
NPI:1518035088
Name:MCHENRY, MELISSA A (DDS,MSD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:DDS,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:55 BRENDON WAY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-1958
Mailing Address - Country:US
Mailing Address - Phone:317-873-4186
Mailing Address - Fax:317-873-1034
Practice Address - Street 1:55 BRENDON WAY
Practice Address - Street 2:SUITE 500
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-1958
Practice Address - Country:US
Practice Address - Phone:317-873-4186
Practice Address - Fax:317-873-1034
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010176A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry