Provider Demographics
NPI:1083805568
Name:CHENG, MELISSA (DDS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CHENG
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 1:1111 W TOWN AND COUNTRY RD STE 33
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4667
Mailing Address - Country:US
Mailing Address - Phone:714-285-0505
Mailing Address - Fax:714-285-0988
Practice Address - Street 1:1111 W TOWN AND COUNTRY RD STE 33
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4667
Practice Address - Country:US
Practice Address - Phone:714-285-0505
Practice Address - Fax:714-285-0988
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35860122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist