Healthcare Provider Details

I. General information

NPI: 1811232093
Provider Name (Legal Business Name): MELISSA A DEMPSEY, DDS MS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 W FIGARDEN DR
FRESNO CA
93722-6057
US

IV. Provider business mailing address

4005 W FIGARDEN DR
FRESNO CA
93722-6057
US

V. Phone/Fax

Practice location:
  • Phone: 559-226-7468
  • Fax: 559-226-2678
Mailing address:
  • Phone: 559-226-7468
  • Fax: 559-226-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number43935
License Number StateCA

VIII. Authorized Official

Name: MELISSA A DEMPSEY
Title or Position: OWNER
Credential: DDS MS
Phone: 559-226-7468