Provider Demographics
NPI:1467696013
Name:MARTINEZ, MELINA LUJAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELINA
Middle Name:LUJAN
Last Name:MARTINEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3769 TRANQUILITY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7702
Mailing Address - Country:US
Mailing Address - Phone:702-994-4299
Mailing Address - Fax:702-360-3426
Practice Address - Street 1:3769 TRANQUILITY RIDGE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7702
Practice Address - Country:US
Practice Address - Phone:702-994-4299
Practice Address - Fax:702-360-3426
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist