MEDICARE: ARTHUR MALAYEV D.D.S

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	390200000X	Student in an Organized Health Care Education/Training Program
2	122300000X	Dentist	058638-1	NY

General Provider Information

NPI Number	:	1679952774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR MALAYEV D.D.S

Provider Business Mailing Address
First Line	:	15056 77TH AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-3126
Country	:	US
Telephone Number	:	347-510-1950
Fax Number	:

Provider Business Practice Location Address
First Line	:	15056 77TH AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11367-3126
Country	:	US
Telephone Number	:	347-510-1950
Fax Number	:

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

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	02/23/2017

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