Provider Demographics
NPI:1932062387
Name:MELANIE HAIRSTON, DDS, PLLC
Entity type:Organization
Organization Name:MELANIE HAIRSTON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-340-6876
Mailing Address - Street 1:1454 WAVERLY ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-5944
Mailing Address - Country:US
Mailing Address - Phone:336-340-6876
Mailing Address - Fax:336-340-6876
Practice Address - Street 1:692 HANES MALL BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-5670
Practice Address - Country:US
Practice Address - Phone:336-340-6876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty