Active NPI
Robert Malik, D.D.S.
- Dentist
- Michigan City, IN
National Provider Identifier
1285045476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12007493
- Practice address
- 817 Washington St
Michigan City, IN 46360-3509 - Phone
- (219) 874-7645
- NPI assigned
- May 11, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 12007493 | IN | Primary |
Addresses
Primary practice location
817 Washington St
Michigan City, IN 46360-3509
Mailing address
817 Washington St
Michigan City, IN 46360-3509
Phone (219) 874-7645
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12007493 | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399766400000",
"number": "1285045476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 WASHINGTON ST",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463603509",
"telephone_number": "219-874-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 WASHINGTON ST",
"city": "MICHIGAN CITY",
"state": "IN",
"postal_code": "463603509",
"telephone_number": "219-874-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIK",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-11",
"last_updated": "2014-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12007493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Michigan City, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.