Malik Al-Grouz, DMD
Individual provider Active NPI Dentist · Lompoc, CA
NPI 1447811310 · NPPES record last updated Jul 18, 2023
Key facts
- NPI
- 1447811310
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.034519 (IL)
- Practice address
- 1009 N H St Ste P
Lompoc, CA 93436-8141 - Phone
- (805) 242-4044
- NPI assigned
- Jun 21, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103832 | CA | MD | Social Worker |
| 019.034519 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Algrouz Dental Group | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 103832 | CA | |
| Dentist | 122300000X | 019.034519 | IL | Yes |
Addresses
Primary practice location
1009 N H St Ste P
Lompoc, CA 93436-8141
Mailing address
910 W Huron St Unit 1405
Chicago, IL 60642-5980
Phone (708) 638-6135
Other providers in Lompoc, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.