Provider Demographics
NPI:1548558158
Name:WARD, MELODY D (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MELODY
Middle Name:D
Last Name:WARD
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:MELODY
Other - Middle Name:
Other - Last Name:DAROOGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:6080 FALLS RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2498
Mailing Address - Country:US
Mailing Address - Phone:410-372-0202
Mailing Address - Fax:410-372-0311
Practice Address - Street 1:6080 FALLS RD STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2498
Practice Address - Country:US
Practice Address - Phone:410-372-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-17
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15031122300000X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist