Provider Demographics
NPI:1144249798
Name:ZIEGLER, MICHELLE ELAINE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ELAINE
Last Name:ZIEGLER
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:PO BOX 751461
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1461
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:29 BEE ST
Practice Address - Street 2:MUSC AEGD PROGRAM
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-0001
Practice Address - Country:US
Practice Address - Phone:843-792-2188
Practice Address - Fax:843-792-2121
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8801509Medicaid
NJ056220Medicare ID - Type Unspecified
NJ8801509Medicaid