Provider Demographics
NPI:1306536123
Name:BENDER, MELANYE (DMD)
Entity type:Individual
Prefix:
First Name:MELANYE
Middle Name:
Last Name:BENDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LIVINGSTON CV
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7769
Mailing Address - Country:US
Mailing Address - Phone:601-519-7967
Mailing Address - Fax:
Practice Address - Street 1:305 RIO COMMUNITIES BLVD
Practice Address - Street 2:
Practice Address - City:RIO COMMUNITIES
Practice Address - State:NM
Practice Address - Zip Code:87002-6168
Practice Address - Country:US
Practice Address - Phone:505-864-2978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NM390200000X
NMDB-2025-00941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program