Provider Demographics
NPI:1891714143
Name:COMBS, MELISSA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:COMBS
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 1:11401 NALL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1850
Mailing Address - Country:US
Mailing Address - Phone:913-663-4867
Mailing Address - Fax:
Practice Address - Street 1:11401 NALL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1850
Practice Address - Country:US
Practice Address - Phone:913-663-4867
Practice Address - Fax:785-272-0035
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020160221223P0300X
KS601491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics