Healthcare Provider Details

I. General information

NPI: 1124071394
Provider Name (Legal Business Name): MELVIN A KAYE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 GARRETT RD
DREXEL HILL PA
19026-1101
US

IV. Provider business mailing address

7 LUMBERMILL LANE
VOORHEES NJ
08043-4764
US

V. Phone/Fax

Practice location:
  • Phone: 610-284-1200
  • Fax: 610-284-3712
Mailing address:
  • Phone: 856-309-0027
  • Fax: 856-309-1993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS016451L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: