Provider Demographics
NPI:1447563226
Name:RODAS, MELISSA MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MARIA
Last Name:RODAS
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 1:19581 POMPANO LN UNIT 103
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6407
Mailing Address - Country:US
Mailing Address - Phone:310-227-7339
Mailing Address - Fax:
Practice Address - Street 1:19581 POMPANO LN UNIT 103
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6407
Practice Address - Country:US
Practice Address - Phone:310-227-7339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59437122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist