Paul Michel Mallouk, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

41025 Issued in CA

Practice address

1317 Main St
Delano, CA 93215-1737

Phone

(661) 725-9105

Fax

(661) 720-9123

NPI assigned

May 24, 2005

Last updated

Mar 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Paul Mallouk DDS PC

  dba Paul Mallouk DDS

  • General Practice Dentistry
  • Delano, CA
  • NPI 1053023945
  NPD (past)
• Paul S Singh OB-GYN Urogynecology Inc

  dba Paul S Singh OB/GYN Urogyncology Inc

  • Obstetrics & Gynecology Physician
  • Tehachapi, CA
  • NPI 1386816353
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1053314872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 MAIN ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151737",
            "telephone_number": "661-725-9105",
            "fax_number": "661-720-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 MAIN ST",
            "city": "DELANO",
            "state": "CA",
            "postal_code": "932151737",
            "telephone_number": "661-725-9105",
            "fax_number": "661-720-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOUK",
        "first_name": "PAUL",
        "middle_name": "MICHEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B41025",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonelyn Magbitang
• Kristoffer Ryan Magbitang, PTA
• Brian Joseph Main, PSY.D.
• Brenda Berenice Maldonado
• Jasmin Elicea Maldonado
• Rishi Manchanda, M.D., M.P.H.
• Manuel Palau DDS Inc
• Miguel Angel Mariscal Franco, CHW
• Savannah Marquez
• Eva Martinez Garcia

• Dentist in Delano, CA
• Providers in Delano, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.