Active NPI
Morad R Malaki, DMD
- Dentist
- Phoenix, AZ
National Provider Identifier
1114095478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D5701
- Practice address
- 3608 W Camelback Rd
Phoenix, AZ 85019 - Phone
- (602) 544-2480
- Fax
- (602) 242-4267
- NPI assigned
- Dec 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D5701 | AZ | Primary |
Addresses
Primary practice location
3608 W Camelback Rd
Phoenix, AZ 85019
Mailing address
1739 E Broadway Rd
Ste #171
Tempe, AZ 85282
Phone (267) 235-9074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 715245 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5701 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven C. Chang DDS PC | Past | Accepting new patients | |
| Steven C. Chang DDS PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Phoenix, AZ
- NPI 1255721148
-
- Customized Equipment (DME)
- Glendale, AZ
- NPI 1487389573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114095478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1739 E BROADWAY RD",
"address_2": "STE #171",
"city": "TEMPE",
"state": "AZ",
"postal_code": "85282",
"telephone_number": "267-235-9074",
"fax_number": "602-242-4267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3608 W CAMELBACK RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85019",
"telephone_number": "602-544-2480",
"fax_number": "602-242-4267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALAKI",
"first_name": "MORAD",
"middle_name": "R",
"name_prefix": "Mr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D5701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "715245",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.