Individual provider Active NPI

Waheed A Malik, D.D.S.

  • Endodontics
  • Duluth, GA
National Provider Identifier
1487863262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN011834 Issued in GA
Practice address
2405 Satellite Blvd.
Suite 115
Duluth, GA 30096
Phone
(770) 495-8088
Fax
(770) 495-8085
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DN011834 GA Primary

Addresses

Primary practice location

2405 Satellite Blvd.
Suite 115
Duluth, GA 30096

Mailing address

2479 Oak Hill Overlook
Duluth, GA 30097
Phone (770) 495-8088

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
DN011834GAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487863262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 OAK HILL OVERLOOK",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-495-8088",
            "fax_number": "770-495-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 SATELLITE BLVD.",
            "address_2": "SUITE 115",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "30096",
            "telephone_number": "770-495-8088",
            "fax_number": "770-495-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "WAHEED",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "DN011834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.