MEDICARE: MALAK HAMEDIAN

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	122300000X	Dentist	8312	NV

General Provider Information

NPI Number	:	1255982914
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALAK HAMEDIAN

Provider Business Mailing Address
First Line	:	3350 NOVAT ST STE 145
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8722
Country	:	US
Telephone Number	:	702-707-6895
Fax Number	:

Provider Business Practice Location Address
First Line	:	3350 NOVAT ST STE 145
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8722
Country	:	US
Telephone Number	:	702-707-6895
Fax Number	:

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

Provider Enumeration Date	:	09/24/2019
Last Update Date	:	10/28/2025

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Directions to “ MALAK HAMEDIAN ” Practice Location

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