Healthcare Provider Details

I. General information

NPI: 1720491558
Provider Name (Legal Business Name): MELISSA PINTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2014
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STATE ST STE 3
HACKENSACK NJ
07601-8911
US

IV. Provider business mailing address

120 STATE ST STE 3
HACKENSACK NJ
07601-8911
US

V. Phone/Fax

Practice location:
  • Phone: 201-343-4483
  • Fax: 201-383-1999
Mailing address:
  • Phone: 201-343-4483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02598100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: