Provider Demographics
NPI:1063604718
Name:MELAMED, JUDY YUDITA (DDS)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:YUDITA
Last Name:MELAMED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 YORK RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6042
Mailing Address - Country:US
Mailing Address - Phone:410-821-5553
Mailing Address - Fax:410-825-7213
Practice Address - Street 1:1407 YORK RD STE 210
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-821-5553
Practice Address - Fax:410-825-7213
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics