Provider Demographics
NPI:1144112608
Name:STAIR, MELISSA JEAN (RDH)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:JEAN
Last Name:STAIR
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:JEAN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:1434 N MCALLISTER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85288-1524
Mailing Address - Country:US
Mailing Address - Phone:602-642-7194
Mailing Address - Fax:
Practice Address - Street 1:1434 N MCALLISTER AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-1524
Practice Address - Country:US
Practice Address - Phone:602-642-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH007082124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist