NPIMap

Organization Active NPI

Dr Charles Malkemus Inc

  • General Practice Dentistry
  • Dorchester, MA
National Provider Identifier
1508977547
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
MA11207 Issued in MA
Legal business name
DR CHARLES MALKEMUS INC
Practice address
166 Columbia Rd
Dorchester, MA 02121-3411
Phone
(617) 445-9880
Fax
(617) 445-5746
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Charles M Malkemus, DDS, JDNPI 1083724090
Title
President
Phone
(617) 445-9880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X MA11207 MA Primary

Addresses

Primary practice location

166 Columbia Rd
Dorchester, MA 02121-3411

Mailing address

166 Columbia Rd
Dorchester, MA 02121-3411
Phone (617) 445-9880

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508977547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021213411",
            "telephone_number": "617-445-9880",
            "fax_number": "617-445-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 COLUMBIA RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021213411",
            "telephone_number": "617-445-9880",
            "fax_number": "617-445-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CHARLES MALKEMUS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALKEMUS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-445-9880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, JD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "MA11207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.