Provider Demographics
NPI:1235117573
Name:DEMARIA, MELANIE ELAINE (DMD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:ELAINE
Last Name:DEMARIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:ELAINE
Other - Last Name:ALLGEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:8988 LORTON STATION BLVD. #101
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079
Mailing Address - Country:US
Mailing Address - Phone:703-256-8554
Mailing Address - Fax:703-256-1029
Practice Address - Street 1:8988 LORTON STATION BLVD. #101
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079
Practice Address - Country:US
Practice Address - Phone:703-541-3110
Practice Address - Fax:703-256-1029
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020082001223G0001X
CA533381223G0001X
VA04014115031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice