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General NPI Number Information
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NPI Number | 1114623170
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Entity Type | Individual
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Provider Name | DIVYA MALIK DENTIST
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 123 N 13TH ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3795
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Country | US
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Telephone | 610-434-9660
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Fax |
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Provider Business Mailing Address
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Address Line | 902 W HAMILTON ST APT 808
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City | ALLENTOWN
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State | PA
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Zip | 18101-1178
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Country | US
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Telephone | 716-239-3011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS044187
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13852
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13852
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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