Healthcare Provider Details

I. General information

NPI: 1912374299
Provider Name (Legal Business Name): MELISSA KENDALL O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2015
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 6TH AVE N
WOLF POINT MT
59201-6000
US

IV. Provider business mailing address

805 ASSINIBOINE AVE
POPLAR MT
59255
US

V. Phone/Fax

Practice location:
  • Phone: 406-653-5616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT-OPT-LIC-4640
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00661600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: