Provider Demographics
NPI:1184291775
Name:HESS, MELAINA HOPE (DMD)
Entity type:Individual
Prefix:DR
First Name:MELAINA
Middle Name:HOPE
Last Name:HESS
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 1:2 GASLIGHT DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:IL
Mailing Address - Zip Code:62286-1129
Mailing Address - Country:US
Mailing Address - Phone:618-318-7161
Mailing Address - Fax:
Practice Address - Street 1:1654 STATE ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:IL
Practice Address - Zip Code:62233-1001
Practice Address - Country:US
Practice Address - Phone:618-826-5017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033164122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist