Healthcare Provider Details

I. General information

NPI: 1306536123
Provider Name (Legal Business Name): MELANYE BENDER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 RIO COMMUNITIES BLVD
RIO COMMUNITIES NM
87002-6168
US

IV. Provider business mailing address

109 LIVINGSTON CV
MADISON MS
39110-7769
US

V. Phone/Fax

Practice location:
  • Phone: 505-864-2978
  • Fax:
Mailing address:
  • Phone: 601-519-7967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDB-2025-0094
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: