Healthcare Provider Details

I. General information

NPI: 1790090462
Provider Name (Legal Business Name): MELANIE ANN NAVARRO JEQUINTO D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 S MAIN ST STE A
SANTA ANA CA
92701-5794
US

IV. Provider business mailing address

29941 AVENTURA STE B
RANCHO SANTA MARGARITA CA
92688-2015
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-6616
  • Fax:
Mailing address:
  • Phone: 949-368-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number59661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: