Maalik Konop-Defreitas

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109508 Issued in CA

Practice address

4425 S Central Ave
Los Angeles, CA 90011-3629

Phone

(323) 908-4200

NPI assigned

Sep 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: maalik.defreitas.p1@direct.scfhc.nextgenshare.com

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1487433256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11131 ROSE AVE APT 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900346019",
            "telephone_number": "651-470-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONOP-DEFREITAS",
        "first_name": "MAALIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mihyun Michelle Kong
• Shana Stacy Kong, MD
• Victor Kong, M.D.
• Kouassi Konian, NP
• Shogo Shawn Kono
• Leron Konowiecki
• Arianna Dionysia Konstantopoulos
• Elena Konstat, PH.D.
• Kanyarat Konsue
• Bintu Konteh, WHNP-BC

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.