Provider Demographics
NPI:1841217601
Name:ANA C MELNYK DENTISTRY
Entity Type:Organization
Organization Name:ANA C MELNYK DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:MELNYK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-352-2669
Mailing Address - Street 1:7150 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2717
Mailing Address - Country:US
Mailing Address - Phone:818-352-2669
Mailing Address - Fax:818-352-4980
Practice Address - Street 1:7150 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2717
Practice Address - Country:US
Practice Address - Phone:818-352-2669
Practice Address - Fax:818-352-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB42366-01OtherDENTI-CAL LICENSE NO