Maleeha Ishaak Mallic, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401417724 Issued in VA

Practice address

5630 Plank Rd
Fredericksburg, VA 22407-6641

Phone

(540) 548-3602

NPI assigned

Jun 28, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Neibauer Dental Care, PC

  dba Neibauer Dental Care - Harrison Crossing

  • General Practice Dentistry
  • Fredericksburg, VA
  • NPI 1821365248
  NPD (past)

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1356902480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 MERRILY WAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 PLANK RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224076641",
            "telephone_number": "540-548-3602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251B Saratoga Ave NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200181025",
            "country_code": "US",
            "telephone_number": "202-469-4699",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "67 5th Ave",
            "address_2": "B-3a",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "17201",
            "country_code": "US",
            "telephone_number": "540-840-1661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLIC",
        "first_name": "MALEEHA",
        "middle_name": "ISHAAK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042290",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DC",
            "license": "DEN1002121",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Maldonado
• Auryana J Malek
• Rosalind Barrett Malhotra, NP
• Christine Malie, DPT
• Lisa Marie Malinowski, CRNA
• Renee Malove, FNP-C
• Marisol Maltes, RN
• Brittany Leigh Mammucari, CCC-SLP
• Jessica Lindsay Manahan, MS CCC-SLP
• Partam Manalai, M.D

• Dentist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.