Provider Demographics
NPI:1164316634
Name:RAFULS, MELISSA (DMD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:RAFULS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ORQUIDEA
Other - Middle Name:NELIZA
Other - Last Name:RAFULS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:314 CAMPUS VIEW ST APT 1
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-7928
Mailing Address - Country:US
Mailing Address - Phone:786-925-8095
Mailing Address - Fax:
Practice Address - Street 1:2510 HENDERSON DRIVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846
Practice Address - Country:US
Practice Address - Phone:620-272-0570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-07
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS623221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice