MEDICARE: SAM MALCHEFF DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901018630	MI
2	1223P0221X	Pediatric Dentistry	2901018630	MI

General Provider Information

NPI Number	:	1124221312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAM MALCHEFF DDS

Provider Business Mailing Address
First Line	:	1657 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2948
Country	:	US
Telephone Number	:	734-335-7270
Fax Number	:	734-763-8100

Provider Business Practice Location Address
First Line	:	1657 N CANTON CENTER RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2948
Country	:	US
Telephone Number	:	734-335-7270
Fax Number	:	734-763-8100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	06/26/2025

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Directions to “ SAM MALCHEFF DDS” Practice Location

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