=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477475739
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NICHOLAS PAUL MALINOWSKI DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2026
-----------------------------------------------------
Last Update Date | 07/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7723 CLEARVIEW CHURCH LN
-----------------------------------------------------
City | LYLES
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37098-1674
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-589-6733
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4423 CLEARVIEW CHURCH RD
-----------------------------------------------------
City | LYLES
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-589-6733
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 13157
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------