Provider Demographics
NPI:1649465717
Name:KARAHROODI, MELINDA (DDS)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:KARAHROODI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:PASCUA
Other - Last Name:AFRAEE-KARAHROODI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9602 PARTRIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-7859
Mailing Address - Country:US
Mailing Address - Phone:956-568-1938
Mailing Address - Fax:
Practice Address - Street 1:2316 S ZAPATA HWY
Practice Address - Street 2:SUITE 190
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-6563
Practice Address - Country:US
Practice Address - Phone:925-864-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice