Provider Demographics
NPI:1659861664
Name:MEADOR-SCHULTE, MERIDETH E (DDS)
Entity Type:Individual
Prefix:DR
First Name:MERIDETH
Middle Name:E
Last Name:MEADOR-SCHULTE
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 1:4157 40TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3444
Mailing Address - Country:US
Mailing Address - Phone:612-300-0031
Mailing Address - Fax:
Practice Address - Street 1:14505 GLAZIER AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7550
Practice Address - Country:US
Practice Address - Phone:952-432-1101
Practice Address - Fax:952-432-9798
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND139901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice