Individual provider Active NPI

Sam Malcheff, DDS

  • Pediatric Dentistry
  • Canton, MI
National Provider Identifier
1124221312
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2901018630 Issued in MI
Practice address
1657 N Canton Center Rd
Canton, MI 48187-2948
Phone
(734) 335-7270
Fax
(734) 763-8100
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018630 MI
Pediatric Dentistry 1223P0221X 2901018630 MI Primary

Addresses

Primary practice location

1657 N Canton Center Rd
Canton, MI 48187-2948

Mailing address

1657 N Canton Center Rd
Canton, MI 48187-2948
Phone (734) 335-7270

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

LicenseStateTypeSpecialty
2901018630MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Canton Pediatric Dentistry, PLLC Pediatric Dentistry PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1124221312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1657 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872948",
            "telephone_number": "734-335-7270",
            "fax_number": "734-763-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 N CANTON CENTER RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872948",
            "telephone_number": "734-335-7270",
            "fax_number": "734-763-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCHEFF",
        "first_name": "SAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018630",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901018630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.