Provider Demographics
NPI:1104042100
Name:OSCAR E VALENZUELA DDS AND PHILIP R MELNICK DMD, INC.
Entity Type:Organization
Organization Name:OSCAR E VALENZUELA DDS AND PHILIP R MELNICK DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-860-1611
Mailing Address - Street 1:18000 STUDEBAKER ROAD
Mailing Address - Street 2:SUITE 365
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2690
Mailing Address - Country:US
Mailing Address - Phone:562-860-1611
Mailing Address - Fax:562-865-2245
Practice Address - Street 1:18000 STUDEBAKER RD
Practice Address - Street 2:SUITE 365
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2679
Practice Address - Country:US
Practice Address - Phone:562-860-1611
Practice Address - Fax:562-865-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273921223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty