Healthcare Provider Details

I. General information

NPI: 1962292086
Provider Name (Legal Business Name): MELANIE RANSOM DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 E MCNICHOLS RD
DETROIT MI
48234-3929
US

IV. Provider business mailing address

11200 E MCNICHOLS RD
DETROIT MI
48234-3929
US

V. Phone/Fax

Practice location:
  • Phone: 313-521-6400
  • Fax:
Mailing address:
  • Phone: 313-521-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603197
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: