Provider Demographics
NPI:1659596799
Name:MEIER, MELISSA STUMP (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:STUMP
Last Name:MEIER
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 1:3443 STETTINIUS AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1203
Mailing Address - Country:US
Mailing Address - Phone:513-521-8900
Mailing Address - Fax:513-521-8999
Practice Address - Street 1:8712 WINTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4814
Practice Address - Country:US
Practice Address - Phone:513-521-8900
Practice Address - Fax:513-521-8999
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2698460Medicaid