Provider Demographics
NPI:1902399009
Name:DANG, MELINDA (OD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:DANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1000 TOWNE CENTER BLVD
Mailing Address - Street 2:STE 502
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4068
Mailing Address - Country:US
Mailing Address - Phone:912-354-4800
Mailing Address - Fax:912-629-5821
Practice Address - Street 1:741 WEEPING WILLOW DR STE A
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-3912
Practice Address - Country:US
Practice Address - Phone:912-368-2522
Practice Address - Fax:912-877-0185
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003085152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist