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NPI Code Detail

MEDICARE: DR. MELISSA VILLAFANE DMD

MEDICARE: DR. MELISSA VILLAFANE DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019.031593IL

General Provider Information

NPI Number : 1851885453
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA VILLAFANE DMD
Provider Business Mailing Address
First Line : 200 W PARKVIEW DR
Second Line :
City : ADDISON
State : IL
Zip : 60101-3727
Country : US
Telephone Number : 630-532-0207
Fax Number :
Provider Business Practice Location Address
First Line : 4148 S ARCHER AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60632-1825
Country : US
Telephone Number : 773-247-3345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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