Provider Demographics
NPI:1801488465
Name:NELMS, MERISSA FERRAR (DDS)
Entity type:Individual
Prefix:DR
First Name:MERISSA
Middle Name:FERRAR
Last Name:NELMS
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 1:870 GAINES SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3132
Mailing Address - Country:US
Mailing Address - Phone:706-546-7473
Mailing Address - Fax:706-549-0973
Practice Address - Street 1:870 GAINES SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3132
Practice Address - Country:US
Practice Address - Phone:706-546-7473
Practice Address - Fax:706-549-0973
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224P00000X, 390200000X
GADN1224191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program