Individual provider Active NPI

Alevtina Malakova, D.D.S.

  • Dentist
  • Elmhurst, NY
National Provider Identifier
1003196445
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055748 Issued in NY
Practice address
9123 Queens Blvd Ste B
Elmhurst, NY 11373-5559
Phone
(718) 205-2055
Fax
(718) 205-2355
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055748 NY Primary

Addresses

Primary practice location

9123 Queens Blvd Ste B
Elmhurst, NY 11373-5559

Mailing address

10025 Queens Blvd Apt 5S
Forest Hills, NY 11375-2460
Phone (718) 744-4811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717001271 NY Order and Referring Only - DentistPractitioner - Dentist 7416260567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tina Malakova Dental Services P.C. CurrentSince Nov 17, 2019 Accepting new patients
Bright Dental Services PLLC Current Accepting new patients
Love My Smile Dental PC PastSince Nov 17, 2019 Accepting new patients
Steinway Family Dental Center Dentist Past Accepting new patients
Always Smile Dental PLLC Past Accepting new patients

Locations

9123 Queens Blvd
Ste B
Elmhurst, NY 11373
Phone (718) 205-2055

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1003196445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 QUEENS BLVD APT 5S",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752460",
            "telephone_number": "718-744-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9123 QUEENS BLVD STE B",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735559",
            "telephone_number": "718-205-2055",
            "fax_number": "718-205-2355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKOVA",
        "first_name": "ALEVTINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.