Provider Demographics
NPI:1760725048
Name:DEREGHISHIAN, MELINEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELINEH
Middle Name:
Last Name:DEREGHISHIAN
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 1:6837 WEXFORD PL
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-3235
Mailing Address - Country:US
Mailing Address - Phone:818-331-4418
Mailing Address - Fax:
Practice Address - Street 1:6837 WEXFORD PL
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-3235
Practice Address - Country:US
Practice Address - Phone:818-331-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-04
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLL-316-12122300000X
NV6456122300000X
CA64426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist