Provider Demographics
NPI:1598043655
Name:NENSEL, MELISSA ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:ANNE
Last Name:NENSEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CARTER LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51510-1438
Mailing Address - Country:US
Mailing Address - Phone:712-347-6151
Mailing Address - Fax:
Practice Address - Street 1:3004 N 13TH ST
Practice Address - Street 2:
Practice Address - City:CARTER LAKE
Practice Address - State:IA
Practice Address - Zip Code:51510-1438
Practice Address - Country:US
Practice Address - Phone:712-347-6151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice