Healthcare Provider Details

I. General information

NPI: 1922536150
Provider Name (Legal Business Name): MELINDA SUZANNE PRADO RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 S CAMPBELL AVE
GREEN VALLEY AZ
85614-0504
US

IV. Provider business mailing address

1260 S CAMPBELL AVE
GREEN VALLEY AZ
85614-0504
US

V. Phone/Fax

Practice location:
  • Phone: 520-407-5600
  • Fax: 520-407-5990
Mailing address:
  • Phone: 520-407-5600
  • Fax: 520-407-5990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH007251
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: