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General NPI Number Information
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NPI Number | 1073999215
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Entity Type | Individual
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Provider Name | MELANIE ANNE WHALEN DMD
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | US HWY 491 NORTH
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City | SHIPROCK
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State | NM
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Zip | 87420
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Country | US
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Telephone | 336-716-3882
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | SHIPROCK
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State | NM
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Zip | 87420-0160
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Country | US
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Telephone | 505-368-6001
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Fax | 505-368-6360
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DT2602
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DT-11752
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License Number State | NC
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