Provider Demographics
NPI:1255062659
Name:ZASADNY, MELANIE THERESA (DDS)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:THERESA
Last Name:ZASADNY
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 1:5010 EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3092
Mailing Address - Country:US
Mailing Address - Phone:319-939-6935
Mailing Address - Fax:
Practice Address - Street 1:4015 HURST DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-9035
Practice Address - Country:US
Practice Address - Phone:319-235-6287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADS-099931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice