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NPI Code Detail

MEDICARE: MELISSA J FLANNERY RDH

MEDICARE: MELISSA J FLANNERY RDH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist11406WI

General Provider Information

NPI Number : 1598197469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA J FLANNERY RDH
Provider Business Mailing Address
First Line : PO BOX 959
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53082-0959
Country : US
Telephone Number : 920-783-6633
Fax Number : 920-783-6392
Provider Business Practice Location Address
First Line : 1721 SAEMANN AVE
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53081-2342
Country : US
Telephone Number : 920-783-6633
Fax Number : 920-783-6392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 09/12/2025

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Directions to “ MELISSA J FLANNERY RDH” Practice Location

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