Healthcare Provider Details

I. General information

NPI: 1841217601
Provider Name (Legal Business Name): ANA C MELNYK DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7150 FOOTHILL BLVD
TUJUNGA CA
91042-2717
US

IV. Provider business mailing address

7150 FOOTHILL BLVD
TUJUNGA CA
91042-2717
US

V. Phone/Fax

Practice location:
  • Phone: 818-352-2669
  • Fax: 818-352-4980
Mailing address:
  • Phone: 818-352-2669
  • Fax: 818-352-4980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42366
License Number StateCA

VIII. Authorized Official

Name: DR. ANA CECILIA MELNYK
Title or Position: DENTIST
Credential: D.D.S.
Phone: 818-352-2669