Provider Demographics
NPI:1861748790
Name:MEADE, AMANDA FAYE (DDS)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:FAYE
Last Name:MEADE
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 3937
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-3937
Mailing Address - Country:US
Mailing Address - Phone:276-328-5291
Mailing Address - Fax:276-328-2539
Practice Address - Street 1:130 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4106
Practice Address - Country:US
Practice Address - Phone:828-252-3851
Practice Address - Fax:828-254-9067
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413689122300000X
NC108651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist