DR. MELISSA LYNN DAVIS (NPI# 1033649850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033649850 |
| Entity Type | Individual |
| Full Name | DR. MELISSA LYNN DAVIS |
| Credential | D.D.S. |
| Practice Address |
6226 14th Ave Kenosha WI 53143-4413 |
| Mailing Address |
320 E. Armstrong Ave Peoria IL 61603 |
| Practice Telephone | 2626560044 |
| Mailing Telephone | 8475308975 |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1002038 | WI | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | IL | Student, Health Care | |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | LICENSE | 1002038-15 | 01 |
| DENTIST | 123456789 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285160325 | Melissa Davis | Nurse Practitioner | 1228 Harden St Ste A, Columbia, SC 29204-1800 | 2017-05-11 |
| 1245761162 | Melissa Davis | Assisted Living Facility | 4364 Diamond Rd, Winter Haven, FL 33880-1502 | 2017-03-22 |
| 1811358385 | Melissa Davis | Specialist/Technologist | 12226 Collins Drive, King Athletic Center, Emory, VA 24327 | 2016-03-11 |
| 1538524954 | Melissa Davis | Specialist | 276 Rhedia Ln, Hughesville, PA 17737-8363 | 2015-12-30 |
| 1841684040 | Melissa May Davis | Contractor | 311 Newgarden Ave Apt A, Salem, OH 44460-3040 | 2015-03-25 |
| 1942617097 | Melissa Davis | Counselor | 1508 Hoffman, Royal Oak, MI 48067 | 2014-07-21 |
| 1518398981 | Melissa Cook Davis | Physician Assistant | 215 Brightwater Dr, Lillington, NC 27546-5156 | 2013-12-10 |
| 1790113116 | Melissa Davis | Doula | 1224 Irby Dr, Richmond, VA 23225-2904 | 2013-10-22 |
| 1801147152 | Melissa Sam Davis | Social Worker | Corner of Veterans Way and Lamont Street, James H Quillen Va Medical Center, Mountain Home, TN 37684-4000 | 2012-09-26 |
| 1881904118 | Melissa Davis | Licensed Practical Nurse | 85 Thompson St, Staten Island, NY 10304-2729 | 2010-10-20 |
| Street Address |
6226 14TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53143-4413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770789489 | Kenosha Community Health Center, Inc | Family Medicine | 6226 14th Ave, Kenosha, WI 53143 | 2007-06-21 |
| 1609424837 | Heather Nicole Matejka | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-08-30 |
| 1801454269 | Connie Lee Bevry | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2019-05-31 |
| 1841773793 | Donna M Zagame | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2018-09-06 |
| 1043657158 | Tarah Marie Gerner | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2013-05-30 |
| 1467715474 | Craig A. Peterson | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2012-06-25 |
| 1457620031 | Mark Rehorst | Dentist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-12-28 |
| 1962788596 | Robyn L. Bednarek | Dental Hygienist | 6226 14th Ave, Suite 700, Kenosha, WI 53143-4413 | 2011-10-27 |
| 1235415993 | Delores Chovan | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-10-26 |
| 1225312473 | Dara T Brady | Dental Hygienist | 6226 14th Ave, Kenosha, WI 53143-4413 | 2011-10-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891262275 | Shanda L Goecks | Registered Nurse | 6916 26th Ave, Kenosha, WI 53143 | 2018-10-24 |
| 1689942989 | Racine Kenosha Community Action Agency | Public Health or Welfare | 2000 63rd Street, Kenosha, WI 53143 | 2011-12-01 |
| 1538497797 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 7525 Sheridan Rd, Kenosha, WI 53143 | 2009-11-30 |
| 1497929012 | Ebba M Johnson | Physical Therapist | 524 74th Street, Kenosha, WI 53143 | 2008-04-15 |
| 1558413161 | Junith M Thompson | Obstetrics & Gynecology | 6530 Sheridan Road, Kenosha, WI 53143 | 2007-01-17 |
| 1154471332 | Ljh Ambulance, Inc | Ambulance | 6329 28th Ave, Kenosha, WI 53143 | 2007-01-11 |
| 1578625794 | Michael A Schellpfeffer Md Ob Gyn Sc | Obstetrics & Gynecology | 1400 75th Street, Kenosha, WI 53143 | 2006-12-14 |
| 1457468654 | Yasmine S Sido | Physician Assistant | 7550 22nd Ave, Kenosha, WI 53143 | 2006-08-24 |
| 1356307359 | Nancy Jane Houtchens | Dentist | 7533 22nd Ave, Ste 100, Kenosha, WI 53143 | 2006-04-26 |
| 1871566257 | Terry W Huff Dds Sc | Clinic/Center | 6402 Sheridan Rd, Kenosha, WI 53143 | 2006-02-08 |
| Find all providers in zip 53143 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205364197 | Kenosha Dentist LLC | Dentist | 5455 Sheridan Rd Ste 201, Kenosha, WI 53140-3752 | 2017-05-23 |
| 1154782209 | Familia Dental Kenosha LLC | Dentist | 6430 Green Bay Rd, Ste 112, Kenosha, WI 53142-2948 | 2016-03-17 |
| 1831365907 | Martha C. Villasenor | Dentist | 7177 W. Green Bay Rd., 7177 W. Green Bay Rd., Kenosha, WI 53142-1450 | 2008-05-07 |
| 1649464090 | Vincent C Rizzo | Dentist | 7536 39th Avenue, Kenosha, WI 53142 | 2007-08-29 |
| 1972793099 | Robert C. Salituro | Dentist | 3515 75th St, Kenosha, WI 53142-7224 | 2007-07-25 |
| 1821292806 | Robert Stephen Willding | Dentist | 7003 39th Avenue, Kenosha, WI 53142-7132 | 2007-06-13 |
| 1578782520 | Todd Armstrong | Dentist | 7910 39th Ave, Kenosha, WI 53142-2132 | 2007-04-25 |
| 1316063530 | Michael Anthony Walsh | Dentist | 2600 22nd Ave, Kenosha, WI 53140-4813 | 2007-03-21 |
| 1497889216 | Luigi A Caira | Dentist | 4320 60th St, Kenosha, WI 53144-2577 | 2007-03-15 |
| 1740314293 | Charles Marquiss Ashley | Dentist | 7505 38th Ave, Kenosha, WI 53142-4341 | 2007-03-15 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.