MELISSA MAE MOUTRAY (NPI# 1386963718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386963718 |
| Entity Type | Individual |
| Full Name | MELISSA MAE MOUTRAY |
| Credential | M.D DDS |
| Practice Address |
311 Campus Drive Suite 101 Garden City KS 67846 |
| Practice Telephone | 6022720100 |
| Practice Fax Number | 6202710160 |
| Mailing Telephone | 6022720100 |
| Mailing Fax Number | 6202710160 |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2020-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | D1107 | SD | Allopathic & Osteopathic Physicians |
| Street Address |
311 CAMPUS DRIVE SUITE 101 |
| City | GARDEN CITY |
| State | KS |
| Zip Code | 67846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629057088 | Ronald L. Roholt | Dentist | 311 Campus Drive, Suite 101, Garden City, KS 67846 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629619036 | Kayla Thackery | Speech-Language Pathologist | 2735 N Jennie Barker Rd, Garden City, KS 67846 | 2019-10-07 |
| 1477049732 | Sarah Lemmons | Specialist/Technologist | 801 Campus Dr, Athletic Department, Garden City, KS 67846 | 2018-07-10 |
| 1720571813 | Keith Earnest Venjohn | Pharmacist | 3101 East Kansas Ave, Garden City, KS 67846 | 2018-06-13 |
| 1457879017 | Jami Rae Weaver-warren | Nurse Practitioner | 302 N. Fleming Street Suite 2, Garden City, KS 67846 | 2017-09-05 |
| 1659812279 | Cynthia Brungardt | Pharmacist | 2424 N. Taylor Avenuee, Garden City, KS 67846 | 2017-03-15 |
| 1982145595 | Garden City Sr Operatons LLC | Custodial Care Facility | 2002 Labrador Boulevard, Garden City, KS 67846 | 2017-03-15 |
| 1255717559 | United Methodist Mexican American Ministries | Community/Behavioral Health | 122 W. Laurel Street, Garden City, KS 67846 | 2015-08-10 |
| 1447668629 | Zulema Salazar | Registered Nurse | 712 St. John St., Garden City, KS 67846 | 2014-07-31 |
| 1710210943 | Garden Valley Retirement Village, LLC | Skilled Nursing Facility | 1505 East Spruce Street, Garden City, KS 67846 | 2009-09-04 |
| 1720231848 | Vollertsen Family Dentistry | Health Maintenance Organization | 1402 1/2 Kansas Ave., Garden City, KS 67846 | 2008-11-03 |
| Find all providers in zip 67846 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326082223 | Vito A Cardo Jr. | Oral & Maxillofacial Surgery | 81 Nassau Blvd, Garden City, NY 11530 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881258366 | Mid-kansas Oral & Maxillofacial Surgery, LLC | Oral & Maxillofacial Surgery | 3510 N Ridge Rd Ste 500, Wichita, KS 67205-1226 | 2019-04-30 |
| 1356683213 | Prime Healthcare Physician Services - Providence Inc | Oral & Maxillofacial Surgery | 8929 Parallel Pkwy, Kansas City, KS 66112-1689 | 2013-03-19 |
| 1417016270 | Thomas Howard Faerber | Oral & Maxillofacial Surgery | 4601 W 109th St, Suite 118, Overland Park, KS 66211-1318 | 2006-12-07 |
| City | GARDEN CITY |
| Zip Code | 67846 |
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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.