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General NPI Number Information
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NPI Number | 1063296457
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Entity Type | Individual
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Provider Name | MELANIE MCPHERSON DDS
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Gender | Female
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Dates
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Enumeration Date | 08/24/2023
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 515 PROMENADE PKWY APT 402
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City | IRVING
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State | TX
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Zip | 75039-1365
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Country | US
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Telephone | 917-446-7411
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Fax |
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Provider Business Mailing Address
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Address Line | 515 PROMENADE PKWY APT 402
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City | IRVING
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State | TX
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Zip | 75039-1365
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Country | US
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Telephone | 917-446-7411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02991500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40972
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License Number State | TX
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