Provider Demographics
NPI:1689988487
Name:MELCHER, KRISTI SUE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:SUE
Last Name:MELCHER
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 1:10732 VIRGINIA PLAZA
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128
Mailing Address - Country:US
Mailing Address - Phone:402-991-7980
Mailing Address - Fax:
Practice Address - Street 1:707 GRANT ST
Practice Address - Street 2:STE 1
Practice Address - City:ATWOOD
Practice Address - State:KS
Practice Address - Zip Code:67730-1526
Practice Address - Country:US
Practice Address - Phone:785-626-8290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS607291223G0001X
NE70661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice