Rahul Malik, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019029285 Issued in IL

Practice address

2702 West Deyoung Street
Marion, IL 62959

Phone

(205) 639-7259

NPI assigned

Jun 13, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

State licenses

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1134481229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629594950",
            "telephone_number": "205-639-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 WEST DEYOUNG STREET",
            "city": "MARION",
            "state": "IL",
            "postal_code": "62959",
            "telephone_number": "205-639-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "RAHUL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029285",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "10776",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Lynd, BS MHP
• Virginia Leigh Mabrey, LCSW
• Silpa Maddala, M.D
• Parag Arvind Madhani, MD
• Robert Joseph Main, D.D.S.
• Caroline Marie Mallow, MS, CCC-SLP
• Shalynn Malone
• Marvin Richard Mann, MS
• Chrystal T Manning, RN
• Mohammed Yusuf Mansuri, MD

• Dentist in Marion, IL
• Providers in Marion, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2013; 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.