Melody Chou, DMD

Individual provider Active NPI General Practice Dentistry · Winslow, AZ

NPI 1689137457 · NPPES record last updated Feb 27, 2024

Key facts

NPI
1689137457
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
062119 (NY)
Practice address
500 Indiana Ave
Winslow, AZ 86047-2169
Phone
(928) 289-4646
NPI assigned
Apr 9, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
062119NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 062119 NY Yes

Addresses

Primary practice location

500 Indiana Ave
Winslow, AZ 86047-2169

Mailing address

500 Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

Other providers in Winslow, AZ

All providers in Winslow, AZ · General Practice Dentistry in Arizona

Sources for this page

Verify at the official NPI Registry.