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General NPI Number Information
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NPI Number | 1265949903
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Entity Type | Individual
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Provider Name | JODECI MALIXI DMD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 1937 N MILITARY TRL STE U
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-4764
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Country | US
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Telephone | 561-683-7699
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Fax |
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Provider Business Mailing Address
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Address Line | 1274 VIA PANZANI
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8246
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Country | US
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Telephone | 802-829-1311
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0160133837
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.026064
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26760
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License Number State | FL
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