Provider Demographics
NPI:1275645905
Name:PERRY, MELANIE ANGELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:ANGELA
Last Name:PERRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:ANGELA
Other - Last Name:WILCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6222 NE 74TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8158
Mailing Address - Country:US
Mailing Address - Phone:206-543-5800
Mailing Address - Fax:
Practice Address - Street 1:6222 NE 74TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8158
Practice Address - Country:US
Practice Address - Phone:206-543-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMILITARY1223G0001X
WADE000108671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice