Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1033649850 Individual Practitioner Female Practitioner

Dr. Melissa Lynn Davis , DDS

Dentist - General Practice • Kenosha, WI

Professional Overview & Biography Verified Profile Summary

Dr. Melissa Davis, DDS is a registered healthcare professional specializing in Dentist - General Practice in Kenosha, WI. Practice services are available at 6226 14TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6226 14th Ave

Kenosha, WI 531434413

Telephone 2626560044
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Kenosha, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.5 Yrs
Regional Practice Density
56 Specialists

Practicing in Kenosha, WI (2459 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-02-11
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WI 1002038

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID License
1002038-15 (WI)
Commercial Insurance / Payer ID Dentist
123456789

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Cesar Gonzalez , DDS

Dentist - Pediatric Dentistry

NPI 1023005972

Doctor of Dental Surgery

Diane Kosar

Dental Hygienist

NPI 1043466196
NPI 1043657158

Doctor of Dental Surgery

Dr. Hazel Moore , DDS

Dentist - General Practice

NPI 1114914066

Doctor of Dental Surgery

Dr. Michael Mihajlovic , PsyD

Psychologist - Clinical

NPI 1124213954

Doctor of Psychology (Psy.D.)

Hannah Davidson , APSW

Social Worker - Clinical

NPI 1124773627

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location February 11, 2020

Registered at 6226 14TH AVE, KENOSHA, WI 531434413 (Tel: 2626560044)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2020

Student in an Organized Health Care Education/Training Program

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 10, 2020

Dentist (License #1002038 in WI)

NPI Profile Active August 17, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location August 17, 2017

Registered at 320 E. ARMSTRONG AVE, PEORIA, IL 61603 (Tel: 8475308975)

📍
Updated Business Mailing Address August 17, 2017

Registered at 320 E. ARMSTRONG AVE, PEORIA, IL 61603 (Tel: (847) 530-8975)

👤
Provider Name / Credentials Updated August 17, 2017

Recorded as MELISSA DAVIS, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 17, 2017

Student in an Organized Health Care Education/Training Program

NPI Profile Active June 14, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 14, 2017

Registered at 39731 ORCHARD BLUFF LN, WADSWORTH, IL 600839116 (Tel: 8475308975)

📍
Updated Business Mailing Address June 14, 2017

Registered at 39731 ORCHARD BLUFF LN, WADSWORTH, IL 600839116 (Tel: 8475308975)

👤
Provider Name / Credentials Updated June 14, 2017

Recorded as MELISSA DAVIS, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 14, 2017

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration June 14, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1033649850
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 14, 2017
Last Update: February 11, 2020
Sole Proprietor: No

Mailing Address

320 E. Armstrong Ave

Peoria, IL 61603

Phone: 8475308975

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.