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1447374160 NPI number — MANJIT S MALLIK DDS

NPI Number: 1447374160
Health Care Provider/Practitioner: MANJIT S MALLIK DDS

Information about “1447374160” NPI (MANJIT S MALLIK DDS) exists in 1447374160 in HTML format HTML  |  1447374160 in plain Text format TXT  |  1447374160 in PDF (Portable Document Format) PDF  |  1447374160 in an XML format XML  formats.

NPI Number : 1447374160 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1447374160",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MALLIK",
    "FirstName": "MANJIT",
    "MiddleName": "S",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DDS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10 OTSEGO AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DIX HILLS",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11746-8011",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-242-4478",
    "MailingAddressFaxNumber": "631-643-2274",
    "FirstLinePracticeLocationAddress": "9610 57TH AVE",
    "SecondLinePracticeLocationAddress": "#2H",
    "PracticeLocationAddressCityName": "CORONA",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11368-3436",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "718-271-3995",
    "PracticeLocationAddressFaxNumber": "718-271-0021",
    "EnumerationDate": "03/19/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "039145",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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