Individual provider Active NPI

Mahru Malekiha, DMD

  • Dentist
  • Greensburg, PA
National Provider Identifier
1306577192
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS044653 Issued in PA
Practice address
259 Old Route 30 Ste D
Greensburg, PA 15601-6926
Phone
(724) 836-6884
NPI assigned
Jun 22, 2022
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.033653 IL
Dentist 122300000X DN27723 FL
Dentist 122300000X DS044653 PA Primary

Addresses

Primary practice location

259 Old Route 30 Ste D
Greensburg, PA 15601-6926

Mailing address

259 Old Route 30 Ste D
Greensburg, PA 15601-6926
Phone (724) 836-6884

Other practice location 1

2771 Monument Rd Ste 21
Jacksonville, FL 32225-3514
Phone (904) 641-3732

Other practice location 2

2161 Bloomingdale Rd
Glendale Heights, IL 60139-1679
Phone (630) 893-1300

Other practice location 3

76 Stratford Dr
Bloomingdale, IL 60108-2201
Phone (630) 893-5182

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
DN27723FLMDDentist
019.033653ILMDDentist
DS044653PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Petnuch DMD PC PastSince Jun 30, 2024 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1306577192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 OLD ROUTE 30 STE D",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016926",
            "telephone_number": "724-836-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 OLD ROUTE 30 STE D",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156016926",
            "telephone_number": "724-836-6884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2771 Monument Rd Ste 21",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322253514",
            "country_code": "US",
            "telephone_number": "904-641-3732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2161 Bloomingdale Rd",
            "address_purpose": "LOCATION",
            "city": "Glendale Heights",
            "state": "IL",
            "postal_code": "601391679",
            "country_code": "US",
            "telephone_number": "630-893-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "76 Stratford Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601082201",
            "country_code": "US",
            "telephone_number": "630-893-5182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALEKIHA",
        "first_name": "MAHRU",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.033653",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN27723",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS044653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.