Healthcare Provider Details

I. General information

NPI: 1497447601
Provider Name (Legal Business Name): MELODY NEGEEN KIANFARD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20046 VENTURA BLVD
WOODLAND HILLS CA
91364-2637
US

IV. Provider business mailing address

1350 MIDVALE AVE APT 305
LOS ANGELES CA
90024-6342
US

V. Phone/Fax

Practice location:
  • Phone: 818-716-0297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS111003
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: