Individual provider Active NPI

Manav Malik, D.M.D.

  • Pediatric Dentistry
  • Sarasota, FL
National Provider Identifier
1124299193
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN17924 Issued in FL
Practice address
3103 Fruitville Rd
Sarasota, FL 34237
Phone
(941) 953-2111
NPI assigned
Mar 18, 2008
Last updated
Jul 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X TX24260 TX
Pediatric Dentistry 1223P0221X 24260 TX
Pediatric Dentistry 1223P0221X DN17924 FL Primary

Addresses

Primary practice location

3103 Fruitville Rd
Sarasota, FL 34237

Mailing address

3103 Fruitville Rd
Sarasota, FL 34237
Phone (941) 953-2111

Other identifiers 1

IdentifierTypeStateIssuer
195675702MedicaidTX

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
24260TXMDPsychologist
TX24260TXMDDentist
DN17924FLMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
TDN Dentistry PLLC Pediatric Dentistry PastSince Jul 31, 2022 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Manav Malik DMD, PA Pediatric Dentistry Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients

Organizations & group practices 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1124299193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34237",
            "telephone_number": "941-953-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 FRUITVILLE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34237",
            "telephone_number": "941-953-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "MANAV",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "TX24260",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "24260",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN17924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195675702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.