Provider Demographics
NPI:1144515453
Name:MCMENEMY, MEGHAN ERIN (DDS)
Entity type:Individual
Prefix:DR
First Name:MEGHAN
Middle Name:ERIN
Last Name:MCMENEMY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MEGHAN
Other - Middle Name:ERIN
Other - Last Name:AUSHERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:855 N 82ND PLZ
Mailing Address - Street 2:#10
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3591
Mailing Address - Country:US
Mailing Address - Phone:505-450-1152
Mailing Address - Fax:
Practice Address - Street 1:2503 S 140TH CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-2315
Practice Address - Country:US
Practice Address - Phone:402-333-3151
Practice Address - Fax:402-697-9244
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6950122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist