Provider Demographics
NPI:1538415740
Name:MELNIKOV, VLADIMIR (DDS)
Entity type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:MELNIKOV
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 MASON DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-4459
Mailing Address - Country:US
Mailing Address - Phone:214-232-5370
Mailing Address - Fax:
Practice Address - Street 1:3621 MASON DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-4459
Practice Address - Country:US
Practice Address - Phone:214-232-5370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice