Provider Demographics
NPI:1497851968
Name:MELROD, DAVID MATTHEW (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MATTHEW
Last Name:MELROD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 M ST NW
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1445
Mailing Address - Country:US
Mailing Address - Phone:202-659-5986
Mailing Address - Fax:202-296-7169
Practice Address - Street 1:2311 M ST NW
Practice Address - Street 2:SUITE 404
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1445
Practice Address - Country:US
Practice Address - Phone:202-659-5986
Practice Address - Fax:202-296-7169
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC41561223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics