Provider Demographics
NPI:1770143711
Name:ENGEL, MICHELLE ALEXANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ALEXANDRA
Last Name:ENGEL
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 1:5900 BALCONES DR # 26237
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4257
Mailing Address - Country:US
Mailing Address - Phone:737-277-9988
Mailing Address - Fax:
Practice Address - Street 1:TWENTYNINE PALMS MARINE BASE
Practice Address - Street 2:1591
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:92278
Practice Address - Country:US
Practice Address - Phone:760-830-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027739001223G0001X
390200000X
TX412611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program