Provider Demographics
NPI:1982836235
Name:DENTON, MELANIE JADE (OD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:JADE
Last Name:DENTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:MELANIE
Other - Middle Name:JADE
Other - Last Name:DENTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2925 W INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-0764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2925 W INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-0764
Practice Address - Country:US
Practice Address - Phone:734-945-0782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4438152W00000X
NC2148152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist