Provider Demographics
NPI:1699982249
Name:STAMPE, MELODY A (DDS)
Entity type:Individual
Prefix:DR
First Name:MELODY
Middle Name:A
Last Name:STAMPE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 NORTH RENNER ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082
Mailing Address - Country:US
Mailing Address - Phone:972-231-9499
Mailing Address - Fax:972-231-9585
Practice Address - Street 1:1415 NORTH RENNER ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082
Practice Address - Country:US
Practice Address - Phone:972-231-9499
Practice Address - Fax:972-231-9585
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist