Provider Demographics
NPI:1689135295
Name:KOVACEVIC, MELISSA LYN (DMD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LYN
Last Name:KOVACEVIC
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 1:3045 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2317
Mailing Address - Country:US
Mailing Address - Phone:717-798-0077
Mailing Address - Fax:
Practice Address - Street 1:5021 S JELLISON WAY UNIT C
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7378
Practice Address - Country:US
Practice Address - Phone:720-608-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014169341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice