Provider Demographics
NPI:1285049601
Name:ELSNER, MELANIA (DDS)
Entity type:Individual
Prefix:
First Name:MELANIA
Middle Name:
Last Name:ELSNER
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 SW 1ST AVE
Mailing Address - Street 2:APT. 206
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-6182
Mailing Address - Country:US
Mailing Address - Phone:336-908-0827
Mailing Address - Fax:
Practice Address - Street 1:9030 W FORT ISLAND TRL
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-2412
Practice Address - Country:US
Practice Address - Phone:352-795-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN21324122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist